Dresler C M, Fratelli C, Babb J
Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Ann Thorac Surg. 1999 May;67(5):1435-9. doi: 10.1016/s0003-4975(99)00220-9.
Despite an early stage, lung cancer patients often have a poor survival, suggesting inaccurate staging. A pleural lavage demonstrating malignant cells at the time of operation may predict a poorer survival, particularly in patients with otherwise early disease.
Patients, with no preoperative evidence of pleural effusions and undergoing a surgical resection with curative intent, had a preresectional and postresectional lavage to be evaluated by cytology.
Fourteen percent of patients with stage I disease had malignant cells in their preresectional lavage and had a significantly shorter survival than stage I patients with a negative lavage. Positivity of preresectional lavage was not correlated with nodal status, pleural or lymphatic involvement, or histologic findings.
Preoperative pleural lavage should become a standard technique intraoperatively to better characterize and stage patients undergoing lung cancer resections. Patients with malignant cells in their preoperative lavage should be upstaged.
尽管处于早期阶段，但肺癌患者的生存率往往较低，这表明分期不准确。手术时胸膜灌洗发现恶性细胞可能预示着较差的生存率，尤其是在其他方面为早期疾病的患者中。
术前无胸腔积液证据且接受根治性手术切除的患者，在切除术前和切除术后进行灌洗，以进行细胞学评估。
I期疾病患者中有14%在切除术前灌洗中发现恶性细胞，其生存期明显短于切除术前灌洗阴性的I期患者。切除术前灌洗阳性与淋巴结状态、胸膜或淋巴管受累情况或组织学结果无关。
术前胸膜灌洗应成为术中的标准技术，以便更好地对接受肺癌切除术的患者进行特征描述和分期。术前灌洗中有恶性细胞的患者应提高分期。
