Department of Medicine, National University Hospital, Kent Ridge Road, Singapore.
Ther Adv Respir Dis. 2011 Dec;5(6):409-18. doi: 10.1177/1753465811408637. Epub 2011 Jun 22.
Pleural disease in lung cancer can be benign or malignant with the latter carrying a grave prognosis. In this review, we describe and discuss the advances in pleural imaging, procedures, and biomarkers for the diagnosis of pleural diseases in lung cancer. Ultrasound and computed tomography are increasingly applied in the planning of pleural procedures to enhance diagnostic accuracy and safety whilst pleuroscopy gives excellent yield in excess of 93% in the evaluation of cytology negative pleural effusions. Invasion beyond the elastic layer of the visceral pleura upstages lung cancer, and may indicate a need for adjuvant chemotherapy. Biomarkers isolated from pleural fluid or tissue may aid in diagnosis and guide treatment in the future. Magnetic resonance imaging, positron emission tomography, narrow band imaging of the pleura and autofluorescence thoracoscopy are technologies that require further evaluation to better define their respective roles in the diagnostic algorithms of pleural diseases in lung cancer.
肺癌相关的胸膜疾病可为良性或恶性，后者预后极差。本综述中，我们描述并讨论了胸膜疾病在肺癌诊断中的影像学、操作和生物标志物的进展。超声和计算机断层扫描越来越多地应用于胸膜操作的规划中，以提高诊断的准确性和安全性，而胸腔镜检查在细胞学阴性胸腔积液的评估中具有超过 93%的出色检出率。脏层胸膜弹性层的侵犯使肺癌分期升高，可能提示需要辅助化疗。从胸腔积液或组织中分离出的生物标志物可能有助于未来的诊断和治疗。磁共振成像、正电子发射断层扫描、胸膜窄带成像和自体荧光胸腔镜检查是需要进一步评估的技术，以更好地确定它们在肺癌胸膜疾病诊断算法中的各自作用。
