Mori K, Yanase N, Kaneko M, Ono R, Ikeda S
Endoscopic Department, National Cancer Center Hospital, Tokyo, Japan.
Chest. 1989 Feb;95(2):304-8. doi: 10.1378/chest.95.2.304.
This study evaluates the results of preoperative diagnosis on 108 resected cases of peripheral lung cancer with a tumor size of 2 cm or less. Transbronchofiberscopic curettage was performed in 85 cases under x-ray TV fluoroscopy. Only 65 of 85 patients were positive on the initial bronchoscopy (76.5 percent), with repeated bronchoscopy, and 71 of 85 were positive for malignant cells (83.5 percent). The cases for which diagnosis could not be obtained with curettage were those in which the tumor shadow was not visible by x-ray TV fluoroscopy, those in which the lesions arose extramurally compressing the bronchi, or in cases of subpleural lesions. Curettage did not yield a diagnosis in cases with lesions less than 1.1 cm. In cases of small lung cancer lesions, peripheral transbronchofiberscopic curettage should be expected to yield a false-negative rate of approximately 15 percent. Therefore, even when the results of curettage are negative, further detailed examinations including needle biopsy, are necessary to obtain a definitive diagnosis.
本研究评估了108例肿瘤大小为2厘米或更小的周围型肺癌切除病例的术前诊断结果。85例患者在X线电视透视下进行了经支气管纤维镜刮除术。85例患者中，初次支气管镜检查仅65例呈阳性（76.5%），经重复支气管镜检查后，85例中有71例恶性细胞呈阳性（83.5%）。无法通过刮除术获得诊断的病例包括：X线电视透视下看不到肿瘤阴影的病例、病变在壁外生长压迫支气管的病例或胸膜下病变的病例。病变小于1.1厘米的病例，刮除术未得出诊断结果。对于小肺癌病变，经支气管纤维镜周围刮除术的假阴性率预计约为15%。因此，即使刮除术结果为阴性，也需要进行包括针吸活检在内的进一步详细检查以获得明确诊断。
