Broghamer W L, Richards M E, Biscopink R J, Faurest S H
Cancer. 1985 Dec 1;56(11):2664-8. doi: 10.1002/1097-0142(19851201)56:11<2664::aid-cncr2820561122>3.0.co;2-z.
Multiple primary carcinomas of the lung were histologically confirmed in 23 male patients. Five were synchronous neoplasms. Seventeen of the second pulmonary cancers originated in the contralateral lung. The major cell type was epidermoid (17/23), and in 11 patients the tumor was similar in histologic features to the first lesion. Examination of pulmonary secretions as a diagnostic aid in the identification of the second malignant neoplasm was employed for 73.9% (17/23) of the patients. With a single exception, these were obtained at the second diagnostic hospitalization rather than as an outpatient monitoring procedure. Only nine patients had a series of cytologic preparations consisting of three consecutive early morning sputa, bronchial washings/brushings, and a postbronchoscopy sputum. A cytodiagnosis of cancer was established in 82.4% (14/17) of the cases and preceded histologic verification in ten. Radiologic evidence of a second primary was noted in only 56.5% (13/23) of the patients. Pulmonary cytologic examination as a monitoring procedure was not employed in the outpatient follow-up for 64 patients surviving pulmonary cancer for 18 months or longer. Posttherapeutic studies were obtained on 39.1% (25/64) of the hospitalized patients. Thirty-two percent (8/25) were collected concurrently with tissue biopsies for the confirmation of recurrence or metastasis. Patients with primary pulmonary cancers resected for cure should be monitored on a regular basis to include the cytologic examination of three consecutive early morning sputa and a chest radiograph.
23例男性患者经组织学证实为多发性原发性肺癌。其中5例为同时性肿瘤。17例第二原发性肺癌起源于对侧肺。主要细胞类型为鳞状上皮细胞癌（17/23），11例患者的肿瘤组织学特征与首例病变相似。73.9%（17/23）的患者采用检查肺分泌物作为诊断辅助手段来识别第二原发性肿瘤。除1例例外，这些样本均在第二次诊断住院时采集，而非作为门诊监测程序。只有9例患者有一系列细胞学标本，包括连续3次清晨痰液、支气管冲洗/刷检以及支气管镜检查后的痰液。82.4%（14/17）的病例确立了癌症的细胞诊断，其中10例先于组织学确诊。仅56.5%（13/23）的患者有第二原发性肿瘤的放射学证据。64例存活18个月或更长时间的肺癌患者在门诊随访中未采用肺细胞学检查作为监测程序。39.1%（25/64）的住院患者进行了治疗后研究。其中32%（8/25）是在进行组织活检以确认复发或转移时同时采集的。接受根治性切除的原发性肺癌患者应定期进行监测，包括连续3次清晨痰液的细胞学检查和胸部X线片检查。
