Sato M, Saito Y, Nagamoto N, Sagawa M, Kanma K, Takahashi S, Usuda K, Endo C, Fujimura S
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Acta Cytol. 1993 Nov-Dec;37(6):879-83.
In roentgenographically occult lung cancer, it is often difficult to determine the location of the tumor despite the existence of cancer. This complicates diagnosis and points to a need for a more systematic method of examination. Differential brushing was performed on all the respective segmental bronchi in both lungs of 196 patients with positive or suspected positive indications of lung cancer as revealed by sputum cytology. Fifty-nine borderline lesions in 43 cases and 107 lung cancer lesions in 95 cases were diagnosed. Localization was possible in 70.4% of the cases. The diagnosis of borderline lesions was also possible. At the first examination, the rate of localization, as compared with that in the historical control group, improved from 64.1% to 95.8%, and, in particular, an improvement from 0% to 86.2% was noted in those cases in which abnormal bronchoscopic findings were not observed. Concurrent multiple primary cancer was also diagnosed in 12.6% of lung cancer cases before treatment. With this method, cytologic findings in sputum and in specimens obtained by brushing and histologic findings of resected lung can be compared in an integrated manner, and henceforth more accurate diagnostic criteria can be established.
在X线隐匿性肺癌中，尽管存在癌症，但往往难以确定肿瘤的位置。这使诊断变得复杂，并表明需要一种更系统的检查方法。对196例痰细胞学检查显示肺癌阳性或疑似阳性指征患者的双肺各段支气管进行了鉴别刷检。诊断出43例中的59个临界病变和95例中的107个肺癌病变。70.4%的病例能够实现定位。临界病变的诊断也可行。在首次检查时，与历史对照组相比，定位率从64.1%提高到95.8%，特别是在未观察到异常支气管镜检查结果的病例中，定位率从0%提高到86.2%。在治疗前的肺癌病例中，还诊断出12.6%的同时性多原发性癌症。通过这种方法，可以将痰液和刷检标本的细胞学检查结果与切除肺的组织学检查结果进行综合比较，从而建立更准确的诊断标准。
