Hirsch F, Hansen H H, Dombernowsky P, Hainau B
Cancer. 1977 Jun;39(6):2563-7. doi: 10.1002/1097-0142(197706)39:6<2563::aid-cncr2820390638>3.0.co;2-i.
Histologic examination of bone-marrow from the posterior iliac crest was routinely done as a pretreatment staging procedure in 203 consecutive patients with small-cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 27.8% with "fusiform" cell type (WHO II,1), 28.3% with "polygonal" cell type (WHO II,2), 42.8% with "lymphocyte-like" cell type (WHO II,3), and 1.1% with mixed types (WHO II,4). Bone-marrow involvement was found in 17.2%. No significant difference was observed among the histological subtypes with regard to bone-marrow involvement. A comparison of bone-marrow biopsy and aspiration in patients investigated with both procedures showed that aspiration alone was diagnostic in nine of 24 (38%) positive patients as compared with two of 24 (8%) with biopsy alone, while in the remaining 13 patients (54%) both procedures were positive. Of the 35 patients with positive bone-marrow examination, 77% had no other evidence of distant metastatic disease if liver metastases identified by peritoneoscopy and liver biopsy are excluded as a staging procedure. With the exception of thrombocytopenia which was observed in six patients, with bone-marrow metastases, hematological findings were of little value in detecting bone-marrow involvement.
对203例连续性肺小细胞间变性癌患者，常规将髂后上棘骨髓组织学检查作为预处理分期程序。根据世界卫生组织（WHO）分类对患者进行亚型分类，其中“梭形”细胞型（WHO II,1）占27.8%，“多边形”细胞型（WHO II,2）占28.3%，“淋巴细胞样”细胞型（WHO II,3）占42.8%，混合型（WHO II,4）占1.1%。发现17.2%的患者有骨髓受累。各组织学亚型在骨髓受累方面未观察到显著差异。对同时接受骨髓活检和穿刺检查的患者进行比较，结果显示，在24例阳性患者中，仅穿刺检查诊断出9例（38%），而仅活检诊断出2例（8%），其余13例患者（54%）两种检查均为阳性。在35例骨髓检查阳性的患者中，如果将通过腹腔镜检查和肝活检确定的肝转移作为分期程序排除在外，77%的患者没有其他远处转移疾病的证据。除6例有骨髓转移的患者出现血小板减少外，血液学检查结果对检测骨髓受累价值不大。
