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肺癌手术诊断方法的潜力与前景。

The potentialities and prospects for surgical methods of diagnosis of cancer of the lung.

作者信息

Pirogov A I, Wagner R I, Matytsin A N

出版信息

J Surg Oncol. 1980;13(2):99-105. doi: 10.1002/jso.2930130203.

Abstract

Surgical methods of diagnosis make it possible to determine in patients with lung cancer the actual local extension of tumour and its metastatic foci. The diagnostic thoracotomy plays an important role in the complex diagnosis of lung cancer. Diagnostic thoracotomy has been performed in 109 out of 1215 patients with lung cancer and other lung lesions suspicious for cancer. Primary lung cancer, mostly at early stage, was detected in 50 out of 109 patients. Among 308 patients who had been subjected to Daniels operation, metastases were revealed in 130 cases (42.2%); prescalene lymph nodes were found inpalpable in 12.4% and palpable in 64.4% of cases. Mediastinoscopy carried out in 262 patients revealed metastases in 36.2% of cases. Parasternal mediastinotomy allowed definition of the degree of tumor extension in 49.5% of cases. Application of laparoscopy and laparotomy revealed metastases in the organs of the abdominal cavity and retroperitoneal space in 13.5% of patients. Results of studies show a definite relationship between the frequency of metastases development in the lymph nodes and distant organs and tumor site as well as clinico-anatomical forms and morphological structure of tumor. Application of surgical diagnostic methods should be done according to strict indications.

摘要

手术诊断方法能够确定肺癌患者肿瘤的实际局部扩展情况及其转移灶。诊断性开胸手术在肺癌的综合诊断中发挥着重要作用。在1215例患有肺癌及其他疑似癌症的肺部病变患者中,有109例进行了诊断性开胸手术。在这109例患者中,发现50例为原发性肺癌,大多处于早期阶段。在308例接受丹尼尔斯手术的患者中,有130例(42.2%)发现有转移;术前触诊发现前斜角肌淋巴结的病例占12.4%,可触及的病例占64.4%。对262例患者进行的纵隔镜检查显示,36.2%的病例有转移。胸骨旁纵隔切开术在49.5%的病例中能够明确肿瘤扩展程度。腹腔镜检查和剖腹手术显示,13.5%的患者腹腔和腹膜后间隙器官有转移。研究结果表明,淋巴结及远处器官转移的发生率与肿瘤部位以及肿瘤的临床解剖形态和形态结构之间存在一定关系。手术诊断方法的应用应严格按照适应证进行。

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