Sors C, Gonnot G, Longefait H, Guérin R A, Toty L, Hertzog P
Rev Fr Mal Respir. 1979 Dec;7(7):733-7.
The study of the extension of primitive lung cancer involves, on one hand, the determination of the locoregional extension concerning the tumator and adenopathies, and on the other hand, the determination of the metastatic extension. A careful clinical examination determines the need for complementary examinations providing decisive information for or against interventions. Systematic lung endoscopy should consist of staged biopsies. Mediastinoscopy estimates the locoregional extension in a more satisfactory manner than angiography or lung scintigraphies. The search for bone or cerebral metastasis is often negative in the absence of clinical symptomology in spite of the recent contribution of tomodensitometry. The detection of abdominal metastasis by biological examination, scintigraphies or contrast X-rays is liable to interpretational errors in one-third of the cases. It is for this reason that we preconize laparotomy before lung exeresis. In our series, among 175 laparotomies, 35 revealed abdominal metastasis whose discovery enables us to avoid useless, if not harmful, thoracic surgery.
原发性肺癌扩展情况的研究，一方面涉及确定肿瘤及淋巴结的局部区域扩展，另一方面涉及确定转移扩展情况。细致的临床检查确定是否需要进行补充检查，这些检查能为是否进行干预提供决定性信息。系统性肺内镜检查应包括分期活检。纵隔镜检查对局部区域扩展情况的评估比血管造影或肺部闪烁扫描更为令人满意。尽管最近有断层扫描技术的应用，但在没有临床症状的情况下，骨或脑转移的检查结果往往为阴性。通过生物学检查、闪烁扫描或造影X线检查来检测腹部转移，在三分之一的病例中容易出现解释错误。正因如此，我们主张在肺部切除术前进行剖腹手术。在我们的系列研究中，在175例剖腹手术中，有35例发现了腹部转移，这一发现使我们能够避免进行即便无害但也是无用的胸外科手术。
