Doppman J L, Pass H I, Nieman L, Cutler G B, Chrousos G P, Loriaux D L
Diagnostic Radiology Department, Warren G. Magnuson Clinical Center, Bethesda, Maryland 20892.
J Clin Endocrinol Metab. 1989 Dec;69(6):1302-4. doi: 10.1210/jcem-69-6-1302.
Saline lavage of the major bronchial segments was performed in five patients immediately preceding lobectomy to remove an ACTH-producing bronchial carcinoid. Lavage fluid from each bronchus was concentrated, and ACTH determinations were performed. Elevated concentrations of ACTH were not demonstrated in the aspirate from the bronchus containing the known tumor. Two additional patients with ectopic ACTH syndrome from an unknown primary source also underwent selective segmental bronchial lavage for ACTH determination. Neither patient demonstrated ACTH gradients in the lavage specimens. One was found to have an ACTH-producing bronchial carcinoid 18 months after negative lavage. Selective segmental bronchoscopic lavage with measurement of ACTH levels on the aspirate is not an effective technique for detecting ACTH-producing bronchial carcinoid tumor.
在五名患者行肺叶切除术之前，立即对主要支气管节段进行盐水灌洗，以清除产生促肾上腺皮质激素（ACTH）的支气管类癌。对每个支气管的灌洗液进行浓缩，并测定ACTH。在含有已知肿瘤的支气管吸出物中未显示出ACTH浓度升高。另外两名来源不明的异位ACTH综合征患者也接受了选择性节段性支气管灌洗以测定ACTH。两名患者的灌洗标本中均未显示出ACTH梯度。其中一名患者在灌洗结果为阴性18个月后被发现患有产生ACTH的支气管类癌。通过选择性节段性支气管镜灌洗并测量吸出物中的ACTH水平，并非检测产生ACTH的支气管类癌肿瘤的有效技术。
