Miyoshi Tomohiro, Yoshida Junji, Aokage Keiju, Tane Kenta, Ishii Genichiro, Tsuboi Masahiro
Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Heliyon. 2019 Feb 15;5(2):e01240. doi: 10.1016/j.heliyon.2019.e01240. eCollection 2019 Feb.
Sublobar resection in primary lung cancer and pulmonary metastatic tumor can result in recurrence at the surgical margin. Confirming the absence of tumor cells at the cut-end is important. We sought to evaluate the efficacy of intraoperative lavage cytology (ILC) of autostapling cartridges in preventing local failure.
An intraoperative cytology examination was performed in 262 consecutive patients undergoing wedge or segmental resection for 311 lesions, including primary lung cancers and pulmonary metastatic tumors, between April 2004 and April 2010. The data of patients with positive cytology results and those who developed local failure were retrospectively reviewed.
A total of 139 primary lung cancers and 172 pulmonary metastatic tumors (primary site: 120 colorectal and 52 others) were investigated. The results revealed 22 (7%) positive cytology results (11 primary and 11 metastatic). The resection margins of 19 of the 22 lesions with positive cytology were additionally resected. With a median follow-up period of 42 months, recurrence at the margin developed in 2 of the 19 lesions in which additional resection was performed (11%, 1 primary and 1 metastatic). Recurrence at the margin developed in 2 (67%, 1 primary and 1 metastatic) of the 3 lesions in which additional resection was abandoned. Among the 289 lesions showing negative cytology results, recurrence at the margin developed in 7 (2%, 6 primary and 1 metastatic).
ILC of autostapling cartridges in sublobar resection for pulmonary malignant tumor may be useful for assessing the cytological status of the surgical margin.
原发性肺癌和肺转移瘤的亚肺叶切除可能导致手术切缘复发。确认切端无肿瘤细胞很重要。我们旨在评估自动缝合钉仓术中灌洗细胞学检查（ILC）在预防局部复发方面的疗效。
2004年4月至2010年4月期间，对262例连续接受楔形或节段性切除311个病灶（包括原发性肺癌和肺转移瘤）的患者进行了术中细胞学检查。对细胞学结果阳性和发生局部复发的患者数据进行回顾性分析。
共研究了139例原发性肺癌和172例肺转移瘤（原发部位：120例结直肠癌和52例其他肿瘤）。结果显示22例（7%）细胞学结果阳性（11例原发性和11例转移性）。22例细胞学阳性病灶中的19例切除边缘进行了再次切除。中位随访期为42个月，19例进行再次切除的病灶中有2例（11%，1例原发性和1例转移性）出现切缘复发。3例放弃再次切除的病灶中有2例（67%，1例原发性和1例转移性）出现切缘复发。在289例细胞学结果阴性的病灶中，7例（2%，6例原发性和1例转移性）出现切缘复发。
自动缝合钉仓术中灌洗细胞学检查在肺恶性肿瘤亚肺叶切除中可能有助于评估手术切缘的细胞学状态。
