Akaogi E, Ogawa I, Mitsui K, Onizuka M, Ishikawa S, Yamamoto T, Inage Y, Ogata T
Department of Surgery, University of Tsukuba, Japan.
Cancer. 1994 Dec 15;74(12):3113-7. doi: 10.1002/1097-0142(19941215)74:12<3113::aid-cncr2820741209>3.0.co;2-x.
Early lung cancer, not extending beyond the bronchial cartilaginous layer without regional lymph node involvement is considered curable by endoscopic laser therapy or limited surgery. The endoscopic criteria for early squamous cell carcinoma of the bronchus, however, have not yet been determined.
For 44 resected lesions of roentgenographically occult bronchogenic squamous cell carcinomas, the relationship between endoscopic findings and the degree of histologic extent of tumor was examined.
The lesions were divided into three types: polypoid or nodular (PN), flatly spreading (FS), and mixed. Thirty-three lesions arising from the central bronchus included 7, 19, and 7 of the PN, FS, and mixed types, respectively. In the central lesions, the degree of transmural invasion and the greatest dimension correlated, but the degree of intramural invasion of PN-type lesions was higher than that of the FS type. The PN-type lesions smaller than 10 mm and the FS type smaller than 15 mm in greatest dimension were found within the cartilaginous layer without regional lymph node involvement. All lesions of the mixed type were larger than 20 mm. Three of the lesions larger than 20 mm had regional lymph node involvement. All 11 lesions originating in the peripheral bronchus were of the FS type, and a lesion of only 5 mm in greatest dimension had extracartilaginous invasion.
The endoscopic criteria of early squamous cell carcinoma of the bronchus may be applied to central PN lesions smaller than 10 mm and central FS lesions less than 15 mm in greatest dimension. Any lesions of mixed type should be excluded from the criteria.
早期肺癌，若未超出支气管软骨层且无区域淋巴结受累，被认为可通过内镜激光治疗或有限手术治愈。然而，支气管早期鳞状细胞癌的内镜诊断标准尚未确定。
对44例经X线检查隐匿的支气管源性鳞状细胞癌切除病变，研究内镜检查结果与肿瘤组织学浸润程度之间的关系。
病变分为三种类型：息肉样或结节样（PN）、平坦蔓延型（FS）和混合型。起源于中央支气管的33个病变中，PN型、FS型和混合型分别有7个、19个和7个。在中央病变中，透壁浸润程度与最大直径相关，但PN型病变的壁内浸润程度高于FS型。最大直径小于10 mm的PN型病变和小于15 mm的FS型病变位于软骨层内且无区域淋巴结受累。所有混合型病变均大于20 mm。3个大于20 mm的病变有区域淋巴结受累。起源于外周支气管的11个病变均为FS型，最大直径仅5 mm的一个病变有软骨外浸润。
支气管早期鳞状细胞癌的内镜诊断标准可应用于最大直径小于10 mm的中央PN病变和小于15 mm的中央FS病变。任何混合型病变均应排除在该标准之外。
