Drings P
Onkologie. 1980 Jun;3(3):104-11. doi: 10.1159/000214777.
The evaluation of size and histological type of primary tumors of the lung and of the draining regional lymph nodes needs a very extensive diagnostic program. This means a standardized basic program (case history, physical examination, laboratory diagnosis, X-rays of the chest, cytologic evaluation of the sputum, and bronchoscopy), and further examination depending on the findings in the individual patients (lung scan, mediastinoscopy, needle biopsy, angiography, thoracoscopy, and sometimes diagnostic thoracotomy). Looking for distant metastases it is necessary to investigate the most frequently involved organs: the liver (sonography, scan, CAT scan, laparoscopy), the skeleton (scan, X-ray, biopsy), the central nervous system (CAT scan, electroencephalogram, liquor cytology, myelography), and the retroperitoneal space (sonography, CAT scan). It is absolutely necessary to follow this program in patients with small cell carcinoma. Contrary, in patients with other types of lung cancer the whole diagnostic program is indicated when clinical signs evoke suspicion of metastases. The limits of the different diagnostic procedures are discussed.
评估原发性肺癌的大小和组织学类型以及引流区域淋巴结需要非常广泛的诊断程序。这意味着要有一个标准化的基本程序（病史、体格检查、实验室诊断、胸部X光、痰液的细胞学评估以及支气管镜检查），并根据个体患者的检查结果进行进一步检查（肺部扫描、纵隔镜检查、针吸活检、血管造影、胸腔镜检查，有时还包括诊断性开胸手术）。在寻找远处转移时，有必要对最常受累的器官进行检查：肝脏（超声检查、扫描、计算机断层扫描、腹腔镜检查）、骨骼（扫描、X光、活检）、中枢神经系统（计算机断层扫描、脑电图、脑脊液细胞学检查、脊髓造影）以及腹膜后间隙（超声检查、计算机断层扫描）。对于小细胞癌患者，绝对有必要遵循此程序。相反，对于其他类型肺癌患者，当临床体征引起转移怀疑时，应进行整个诊断程序。文中讨论了不同诊断程序的局限性。
