Passlick B, Thetter O, Pantel K, Izbicki J R
Chirurgische Klinik, Klinikum Innenstadt, Universität München.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:779-84.
Despite an apparently curative resection, about 30-40% of the patients with pT1-3, pN0, M0 non-small cell carcinomas (NSCLC) will relapse after surgery. Therefore, it has to be assumed that in some patients a tumor cell dissemination has occurred already at the time of surgery. By using sensitive immunocytochemical techniques, the extent of an early regional and/or systemic tumor cell dissemination can be demonstrated. In pN0 patients, an early lymphatic dissemination can be detected in 15.2% of the cases and a systemic spread of tumor cells into the bone marrow in 54.3%. Since systematic mediastinal lymphadenectomy does not significantly improve the long-term prognosis in these patients, a systemic adjuvant therapy should be offered to patients at risk with a stage I NSCLC.
尽管进行了看似根治性的切除，但pT1-3、pN0、M0期非小细胞肺癌（NSCLC）患者中约30-40%术后会复发。因此，必须假定在某些患者中，手术时肿瘤细胞已经发生播散。通过使用敏感的免疫细胞化学技术，可以证实早期区域和/或全身肿瘤细胞播散的程度。在pN0患者中，15.2%的病例可检测到早期淋巴道播散，54.3%的病例肿瘤细胞可发生全身播散至骨髓。由于系统性纵隔淋巴结清扫术并不能显著改善这些患者的长期预后，因此对于有I期NSCLC风险的患者应提供全身辅助治疗。
