Fushimi H, Kukui M, Morino H, Hosono Y, Fukuoka M, Kusunoki Y, Aozasa K, Matsumoto K
Department of Pathology, Osaka University, Medical School, Suita, Japan.
Cancer. 1992 Aug 1;70(3):599-605. doi: 10.1002/1097-0142(19920801)70:3<599::aid-cncr2820700310>3.0.co;2-9.
In the classification recently proposed by the Pathology Committee of International Association for the Study of Lung Cancer, small cell lung carcinoma (SCLC) was divided into three subtypes: pure SCLC, mixed small cell/large cell carcinoma (mixed SC/LC), and combined SCLC.
To examine the clinical utility of this classification, histologic specimens, cytologic specimens obtained by brushing or fine-needle aspiration, and sputum cytologic specimens from 430 patients with SCLC were reviewed.
When the subtype of SCLC was determined from the biopsy specimen, cytologic specimen obtained by brushing or fine-needle aspiration, and sputum cytologic specimen, the frequency of mixed SC/LC was 25 of 299 (8.4%), 75 of 400 (18.8%), and 8 of 232 (3.4%), respectively. Whatever the diagnostic method, patients with mixed SC/LC showed a poorer response to treatment and worse prognosis than those with pure SCLC: a median survival of 144 days versus 285 days when classified with the use of biopsy specimens; 160 days versus 275 days with cytologic specimens obtained by brushing or fine-needle aspiration; and 47 days versus 259 days with sputum cytologic specimens, respectively.
These findings showed that mixed SC/LC should be separated from pure SCLC as a distinctive group and that cytologic studies of specimens obtained by brushing or fine-needle aspiration were sensitive and useful procedures for this purpose.
在国际肺癌研究协会病理委员会最近提出的分类中，小细胞肺癌（SCLC）被分为三个亚型：纯SCLC、小细胞/大细胞混合癌（混合性SC/LC）和复合型SCLC。
为了检验这种分类的临床实用性，对430例SCLC患者的组织学标本、通过刷检或细针穿刺获得的细胞学标本以及痰细胞学标本进行了回顾。
当从活检标本、通过刷检或细针穿刺获得的细胞学标本以及痰细胞学标本确定SCLC的亚型时，混合性SC/LC的频率分别为299例中的25例（8.4%）、400例中的75例（18.8%）和232例中的8例（3.4%）。无论采用何种诊断方法，混合性SC/LC患者的治疗反应均比纯SCLC患者差，预后也更差：使用活检标本分类时，中位生存期分别为144天和285天；通过刷检或细针穿刺获得的细胞学标本分别为160天和275天；痰细胞学标本分别为47天和259天。
这些发现表明，混合性SC/LC应作为一个独特的组与纯SCLC区分开来，并且通过刷检或细针穿刺获得的标本的细胞学研究是用于此目的的敏感且有用的方法。
