[Pathologic study on the treatment-effect of hematoporphyrin derivative in carcinoma of the gastric cardia].

42 patients with carcinoma of gastric cardia treated by HPD are reported. The endoscopic biopsy specimens of these patients were classified histologically before treatment. There were 2 papillary adenocarcinoma (PAC), 14 well differentiated adenocarcinoma (WDAC), 11 moderate differentiated adenocarcinoma (MDAC), 5 poor differentiated adenocarcinoma (PDAC), 6 mucinous adenocarcinoma (MAC), 1 undifferentiated carcinoma (UDC) and 3 squamous cell carcinoma (SCC). After four weeks' treatment, reexaminations by endoscopy and biopsy were done in 39 patients and operation were performed on three. Histologic changes following the treatment were degeneration, necrosis of tumor cells, and infiltration of lymphocytes and plasmacytes in the stroma to different degrees. The histologic changes were graded into H0, H1, H2 and H3 by the authors. Grades H0, H1 are considered as noneffective and grades H2, H3 as effective. Of 42 patients, 10 were H0, 21 H1, 8 H2 and 3 H3. The overall effective rate was 26.2% (11/42) which was correlated with the histologic type of carcinoma. Thus, 21.4% (3/14) of WDAC, 18% (2/11) of MDAC, 40% (2/5) of PDAC, 50% (3/6) of MAC and 100% (1/1) of UDC responded well to the treatment, but all SCC and PAC were refractory. It should also be noted that the HPD treatment was effective in patients with tumor infiltrations relatively limited and superficial in the gastric wall, but was unsatisfactory in patients with wider and deeper infiltrations.