Steinhäuslin C A, Cuttat J F
Chest. 1985 Nov;88(5):709-13. doi: 10.1378/chest.88.5.709.
Among 338 adults (258 men and 80 women) presenting with spontaneous pneumothorax, there were six men with lung cancer: five squamous cell carcinoma and one oat cell carcinoma. Pneumothorax led to the diagnosis in five cases and the remaining occurred as a complication of known neoplastic disease. The average age was 67 years. We analyze these six cases, along with 46 others from the literature. In patients less than 40 years old with normal chest x-ray film findings after lung expansion, further investigation for neoplastic disease is not justified. However, heavy smoking, chronic bronchitis, bullous emphysema and incomplete lung expansion after chest drainage in patients over 40 years old are indications for cancer screening through sputum cytologic study, bronchoscopic examination and surgical exploration. The occurrence of a pneumothorax neither alters the treatment of the underlying disease nor modifies the one-year prognosis. Five-year survival is nil, suggesting that lung cancers present as pneumothorax at an advanced stage of disease.
在338例出现自发性气胸的成年人（258例男性和80例女性）中，有6例男性患有肺癌：5例鳞状细胞癌和1例燕麦细胞癌。气胸导致5例患者得以确诊，其余患者则是已知肿瘤性疾病的并发症。平均年龄为67岁。我们分析了这6例病例，以及文献中的其他46例病例。对于40岁以下且肺复张后胸部X光片结果正常的患者，进一步进行肿瘤性疾病检查是不合理的。然而，40岁以上患者中重度吸烟、慢性支气管炎、大疱性肺气肿以及胸腔引流后肺复张不全，都是通过痰细胞学检查、支气管镜检查和手术探查进行癌症筛查的指征。气胸的发生既不改变基础疾病的治疗，也不改变一年的预后。五年生存率为零，这表明以气胸形式出现的肺癌处于疾病晚期。
