Pfitzer P, Sygula E, Bernhardt-Huth D
Arch Geschwulstforsch. 1978;48(3):220-32.
It is reported on 275 cases treated for bronchial carcinoma at the Surgical Departement of Düsseldorf University between 1970 and 1974. In all cases cytological as well as histological methods were used for diagnosis. These cases are complemented by 60 cases selected under cytological aspects from other sources. Localization by X-ray proved a central tumor in 11% and tumors in the different lobes in 89% of the cases. Tumors were more frequent in the upper lobes (54%) than in the lower lobes (30%), and more frequent in the right lung (58%) than in the left (42%). Cytological smears were positive or suspicious in 77% of the central carcinoma and in 60 and 56% in cases of roentgenologically peripheral localization. There is no difference found between tumors in the upper and lower lobes. Bronchial secretion renders less positive results for all histological types. This indicates a small area of origin for the cells investigated by this method. Metaplastic cell changes were observed in one third of all cases involving all histological types equally. Operation was possible in only 30% of the cytologically diagnosed cases in comparison to 52% of all cases. The 60 selected cases were composed of 48 primary and twelve secondary tumors. Probatory excision had been performed in 50%, 8% remaining negative even after repetition. 33% could only be verified by autopsy corresponding to 29% with sputa, bronchial aspirate and pleural effusion positive at the same time and therefore regarded as late stages. Negative results can be caused by fibrosis as well as obstruction, fibrosis not being a regular result of treatment with X rays. Differentiation of tumor types is possible in cytological smears. Sometimes differences in the same tumor are evident and occasionally the tumor type can be more distinct in the cytological preparations. Metastatic tumor cells are open to false classification. Tumor and tuberculosis were found in four of sixty cases. One false positive result was caused by cells ressembling cases of experimentally induced bronchiolization of alveoli by different noxa.
据报道，1970年至1974年间，杜塞尔多夫大学外科治疗了275例支气管癌患者。所有病例均采用细胞学和组织学方法进行诊断。另外从其他来源选取了60例经细胞学检查的病例作为补充。经X线定位，11%的病例为中央型肿瘤，89%的病例肿瘤位于不同肺叶。肿瘤在上叶（54%）比在下叶（30%）更常见，在右肺（58%）比在左肺（42%）更常见。中央型癌的细胞学涂片77%呈阳性或可疑，X线表现为外周型的病例中这一比例分别为60%和56%。上下叶肿瘤之间未发现差异。对于所有组织学类型，支气管分泌物的阳性结果较少。这表明通过该方法所研究细胞的起源区域较小。在所有病例的三分之一中观察到化生细胞改变，所有组织学类型均同等程度受累。在细胞学诊断的病例中，仅30%的患者可行手术，而所有病例的这一比例为52%。选取的60例病例包括48例原发性肿瘤和12例继发性肿瘤。50%的病例进行了探查性切除，8%的病例即使重复检查仍为阴性。33%的病例只能通过尸检证实，相当于29%的病例痰液、支气管吸出物和胸腔积液同时呈阳性，因此被视为晚期。阴性结果可能由纤维化以及阻塞引起，纤维化并非X线治疗的必然结果。在细胞学涂片中可以区分肿瘤类型。有时同一肿瘤内存在明显差异，偶尔在细胞学标本中肿瘤类型可能更清晰。转移瘤细胞容易被错误分类。60例病例中有4例同时发现肿瘤和结核。1例假阳性结果是由类似于不同有害因素实验诱导肺泡细支气管化生病例的细胞引起的。
