Ihde D C, Dunnick N R, Johnston-Early A, Bunn P A, Cohen M H, Minna J D
Cancer. 1982 Apr 1;49(7):1485-90. doi: 10.1002/1097-0142(19820401)49:7<1485::aid-cncr2820490729>3.0.co;2-l.
Abdominal computed tomography (CT) was performed as part of the initial staging evaluation in 77 patients with small cell carcinoma (SCC) of the lung. CT scans revealed mass lesions in 26 patients (34%). Abnormalities were confined to the liver in 15 patients and to retroperitoneal structures (lymph nodes, adrenal glands, psoas muscle region masses) in eight, and occurred in both areas in three. However, only three of 29 patients otherwise staged as having limited disease (confined to one hemithorax and regional nodes) had evidence of abdominal metastases on CT scan. Most (23/26) positive studies were in patients already known to have more extensive tumor dissemination. In 71 patients with pathologic confirmation of liver status, CT had a sensitivity of 63%, specificity of 91%, and overall accuracy of 85% in assessing the liver. Comparison of radionuclide liver scan findings with hepatic biopsies gave similar results. During therapy, 65 follow-up CT scans were obtained in 46 patients. Scan abnormalities improved or disappeared in 11/12 cases with tumor response documented in other ways, appeared or worsened in 5/13 cases of tumor progression that was diagnosed by other tests, and only rarely (2/65 scans) improved at the time of documented tumor progression, or vice versa. In only three patients, however, did CT scan provide the sole site of evaluable disease during treatment or detect either the only area of residual disease in a patient in otherwise complete remission or the initial evidence of tumor progression. Although abdominal CT scans in SCC can demonstrate metastatic dissemination not evaluable by other means, they provide relatively little therapeutically relevant information beyond that obtained with standard staging procedures.
对77例肺小细胞癌（SCC）患者进行腹部计算机断层扫描（CT）作为初始分期评估的一部分。CT扫描显示26例患者（34%）有肿块病变。异常情况局限于肝脏的有15例，局限于腹膜后结构（淋巴结、肾上腺、腰大肌区域肿块）的有8例，同时出现在两个区域的有3例。然而，在另外29例分期为局限性疾病（局限于一侧半胸和区域淋巴结）的患者中，只有3例在CT扫描中有腹部转移的证据。大多数（23/26）阳性检查结果出现在已知有更广泛肿瘤播散的患者中。在71例肝脏状况经病理证实的患者中，CT在评估肝脏时的敏感性为63%，特异性为91%，总体准确率为85%。放射性核素肝脏扫描结果与肝活检结果的比较得出了相似的结果。在治疗期间，46例患者进行了65次随访CT扫描。在12例经其他方式记录有肿瘤反应的病例中，11例扫描异常改善或消失；在13例经其他检查诊断为肿瘤进展的病例中，5例扫描异常出现或加重；在记录有肿瘤进展时，扫描异常仅很少（2/65次扫描）改善，反之亦然。然而，在治疗期间，只有3例患者的CT扫描提供了唯一可评估疾病的部位，或检测到处于完全缓解状态的患者中唯一的残留疾病区域或肿瘤进展的初始证据。尽管SCC患者的腹部CT扫描可以显示其他方法无法评估的转移播散，但除了标准分期程序所获得的信息外，它们提供的治疗相关信息相对较少。
