Müller K M, Krismann M, Wiethege T
Institut für Pathologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Bochum.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:770-4.
The aim of the radical resection of lung tumors is curative treatment. However, in each lung tumor of more than 2 cm in diameter an angioinvasion of tumor cells could be proved by morphological means. Frequently, the existence of lymph nodes and especially hematogenic dissemination is underestimated at the time of resection. By pathological-anatomical means in 33% of T1/T2-N2 and 60% of T1/T2-N3 lung tumors, disseminated tumor cells or organoid metastasis in the bone marrow can be demonstrated. Therefore, the demand for radicalness of the surgeon does not agree with a curative tumor therapy in more advanced tumor stages. Actually, the course of the disease following a local radical resection is predominantly predetermined by the individual hematogenic metastatic spread.
肺肿瘤根治性切除的目的是进行治愈性治疗。然而，通过形态学方法可证实，在每例直径超过2 cm的肺肿瘤中，肿瘤细胞均存在血管侵犯。在切除时，淋巴结尤其是血行播散的存在常常被低估。通过病理解剖学方法，在33%的T1/T2-N2和60%的T1/T2-N3肺肿瘤中，可证实骨髓中存在播散的肿瘤细胞或类器官转移。因此，外科医生所要求的根治性与更晚期肿瘤阶段的治愈性肿瘤治疗并不相符。实际上，局部根治性切除后的疾病进程主要由个体血行转移扩散情况预先决定。
