Bejui-Thivolet F, Guérin J C, Salle M, Milox A, Champel F, Vitrey D
Rev Pneumol Clin. 1984;40(5):311-9.
Pleural brushing can be performed under thoracoscopic examination. The combined use of all three methods of diagnosis (macroscopy, biopsy, cytology) achieved optimal diagnostic results. From September 1980 to October 1981 we have performed 150 thoracoscopies for pleural effusions, while the results of conventional pleural cytology and biopsy were negative. In 108 cases pleural brushing and biopsy were both performed. The diagnosis was in 37 cases non malignant disease states associated with effusions and in 71 cases tumoural effusions. Among the 37 cases of non malignant diseases states associated with effusions were 6 mechanical effusions, 27 inflammatory processes, 4 infectious processes. Among the 71 cases of tumoural effusions were 3 benign pleural lipomas, 50 metastatic carcinomas, 18 carcinomatous mesotheliomas. We studied the diagnostic accuracy of pleural brushing: in non malignant diseases pleural brushing show the non tumoural features of the process, in metastatic tumours biopsy was positive in 80% of the cases; pleural brushing in 78% of cases; taken together they allowed the diagnosis in 86% of the cases, in carcinomatous mesotheliomas biopsy was positive in 82.3%, pleural brushing in 78%; taken together they allowed the diagnosis in 89% of the cases. Pleural brushing allows a rapid cytological diagnosis, enhances the histological results and may be used to get cellular material in areas dangerous to biopsy.
胸膜刷检可在胸腔镜检查时进行。三种诊断方法（大体检查、活检、细胞学检查）联合使用可获得最佳诊断结果。1980年9月至1981年10月，我们对胸腔积液患者进行了150例胸腔镜检查，而传统胸膜细胞学检查和活检结果均为阴性。108例患者同时进行了胸膜刷检和活检。诊断结果为：37例为与积液相关的非恶性疾病状态，71例为肿瘤性积液。在37例与积液相关的非恶性疾病状态中，有6例为机械性积液，27例为炎症过程，4例为感染性过程。在71例肿瘤性积液中，有3例为良性胸膜脂肪瘤，50例为转移性癌，18例为癌性间皮瘤。我们研究了胸膜刷检的诊断准确性：在非恶性疾病中，胸膜刷检显示出该过程的非肿瘤特征；在转移性肿瘤中，活检阳性率为80%，胸膜刷检阳性率为78%；两者结合诊断阳性率为86%；在癌性间皮瘤中，活检阳性率为82.3%，胸膜刷检阳性率为78%；两者结合诊断阳性率为89%。胸膜刷检可实现快速细胞学诊断，提高组织学检查结果，并且可用于获取活检危险区域的细胞材料。
