Utsumi Tomoki, Sawabata Noriyoshi, Inoue Masayoshi, Okumura Meinoshin
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Interact Cardiovasc Thorac Surg. 2010 Mar;10(3):434-6. doi: 10.1510/icvts.2009.212142. Epub 2009 Dec 2.
Local recurrence of the tumor after lung excision often occurs in cases with positive cytology results at the surgical stump. Some reports have described the efficacy of margin cytology examinations with various sampling procedures, though an optimum method has not been established. In the period between 2005 and 2008, 58 patients underwent a lung excision followed by a margin cytology examination at our hospital, of whom 49 were finally diagnosed with malignancy. Cytology samples were obtained by scratching the staple lines of both resected and residual lungs, and collecting lavage from washed stapler cartridges used in the procedure, with the results compared. Of the 49 cases with malignancy, 44 underwent both sampling techniques, of which four had positive results, three detected in lavage samples and one by the scratching method. Since neither technique detected all positive cases, it is recommended that samples be obtained using both techniques to avoid missing malignancy.
肺切除术后肿瘤局部复发常见于手术切缘细胞学检查结果为阳性的病例。一些报告描述了采用各种采样程序进行切缘细胞学检查的效果，不过尚未确立最佳方法。2005年至2008年期间，我院有58例患者接受了肺切除手术及切缘细胞学检查，其中49例最终被诊断为恶性肿瘤。通过刮擦切除肺叶和残留肺叶的吻合钉线，并收集术中使用的吻合器钉仓冲洗液来获取细胞学样本，然后比较结果。在49例恶性肿瘤病例中，44例采用了两种采样技术，其中4例结果为阳性，3例在冲洗液样本中检测到，1例通过刮擦法检测到。由于两种技术均未检测出所有阳性病例，因此建议同时使用两种技术获取样本，以避免漏诊恶性肿瘤。
