Butchart E G, Ashcroft T, Barnsley W C, Holden M P
Thorax. 1976 Feb;31(1):15-24. doi: 10.1136/thx.31.1.15.
An analysis is made of the results of pleuropneumonectomy for diffuse malignant pleural mesothelioma in 29 patients and a comparison is made with the results of non-surgical treatment in a further 17 patients. A system of tumour staging is proposed, and the results are correlated with tumour stage and with histological type. Pleuropneumonectomy does not appear materially to affect the course of the disease in cases of mixed epithelial and mesenchymal histological type. However, stage I cases of pure epithelial histological type appear to carry a better prognosis, especially those whose histological structure consists entirely of abundant oedematous mucoid stroma with loosely arranged tumour cells. It is suggested therefore that only epithelial cases should be subjected to pleuropneumonectomy. Means of reducing operative mortality are discussed and alternative methods of treatment described.
对29例弥漫性恶性胸膜间皮瘤患者行胸膜肺切除术的结果进行了分析，并与另外17例非手术治疗的结果进行了比较。提出了一种肿瘤分期系统，并将结果与肿瘤分期和组织学类型相关联。在混合上皮和间叶组织学类型的病例中，胸膜肺切除术似乎对疾病进程没有实质性影响。然而，I期纯上皮组织学类型的病例似乎预后较好，尤其是那些组织结构完全由大量水肿性黏液样基质和排列疏松的肿瘤细胞组成的病例。因此建议仅对上皮性病例行胸膜肺切除术。讨论了降低手术死亡率的方法并描述了替代治疗方法。
