[Cytologic study in assessing the effectiveness of chemotherapy in patients with ovarian cancer]

Chemotherapeutic pathomorphosis has been studied in 179 patients, aged 29 to 70, with mainly disseminated stages of ovarian carcinoma. Fluids from serous cavities, tumor puncture specimens, scrapings off and smears-impressions of removed tumors, puncture specimens and washings from Douglas' pouch have been examined using native smears and smears stained according to Pappenheim. Before therapy fluids from serous cavities (in cases with the ascitic forms) and washings from Douglas' pouch (in non-ascitic forms) have been examined to diagnose the condition. Altogether 114 patients have been examined over the course of therapy and after it. Microscopic changes of the tumor cells due to chemotherapy have been detected in 87% of the patients. Cytograms of 24 patients have shown changes in the nuclei of few tumor cells: pyknosis, karyorrhexis, intensification of the degenerative changes in the cytoplasm, the appearance of bare nuclei, all this indicating a poorly manifest chemotherapeutic pathomorphosis. In 40 cases similar changes have been detected in the majority of tumor cells, sometimes just few intact cells could be found, this being considered as necrosis; 17 patients of this group had a stable remission. Cytograms of 35 patients have shown a still more manifest destruction of the tumor cells and a reduction of their number, which fact is considered as a marked cytolytic effect. In 15 patients no clinical effect of chemotherapy has been observed, this being confirmed by cytologic findings.