Dombernowsky P, Hirsch F, Hansen H H, Hainau B
Cancer. 1978 May;41(5):2008-12. doi: 10.1002/1097-0142(197805)41:5<2008::aid-cncr2820410548>3.0.co;2-i.
Peritoneoscopy with liver biopsy was routinely done as a pretreatment staging procedure in 190 patients with small-cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 28.3% with fusiform cell type (WHO II,1), 28.9% with polygonal cell type (WHO II,2), 41.5% with lymphocytelike cell type (WHO II,3) and 1.3% with mixed types (WHO II, 4). Liver metastases were found in 21% of the patients with adequate liver biopsy. In addition macroscopic signs of liver metastases were observed in 9%. No significant differences were observed among the histological subtypes. Liver function tests, such as alkaline phosphatase, LDH and GOT, were of little value in excluding liver metastases. On the other hand, 2 of 3 abnormal liver function tests were highly indicative of liver metastases. In patients with positive liver biopsy, 41% had liver metastases alone and 76% had no other evidence of distant metastatic disease if bone-marrow involvement identified with bone marrow examination is excluded as a staging procedure.
对190例肺小细胞间变性癌患者，常规进行腹腔镜检查及肝活检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划分，其中梭形细胞型（WHO II,1）占28.3%，多边形细胞型（WHO II,2）占28.9%，淋巴细胞样细胞型（WHO II,3）占41.5%，混合型（WHO II,4）占1.3%。在肝活检充分的患者中，21%发现有肝转移。另外，9%观察到有肝转移的宏观体征。各组织学亚型之间未观察到显著差异。肝功能检查，如碱性磷酸酶、乳酸脱氢酶和谷草转氨酶，在排除肝转移方面价值不大。另一方面，三项肝功能检查中有两项异常高度提示肝转移。在肝活检阳性的患者中，若作为分期程序排除骨髓检查发现的骨髓受累情况，41%仅有肝转移，76%无其他远处转移疾病的证据。
