Buhr J, Berghäuser K H, Gonner S, Schäffer R, Padberg W M
Klinik für Allgemein- und Thoraxchirurgie, Justus-Liebig-Universität, Giessen.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:798-804.
Tumor cell detection in lavage fluids might be a prognostic factor in solid tumors. Therefore, 342 patients with the first manifestation of lung cancer underwent intraoperative pleural lavage (lavage I = after opening the chest; lavage II = after resection of lung cancer). Tumor cells were found in lavage I in 132 patients (38.6%), in 99 of them also in lavage II. We found tumor cells in only nine cases in lavage II cytologically. The cumulative 5 year survival rate of non-small cell lung cancer in stage I (n = 164) was 25.9% if lavage was positive (lavages I and II, n = 47), and 69.2% if lavage was negative (n = 117) (p < 0.05). Additionally, we performed tissue cultures of tumor-free parenchyma in 23 cases of lung cancer. In 16 cases (69.6%), we detected tumor cells by histology and immunohistology. Cytologic tumor cell detection in intraoperative pleural lavage in lung cancer seems to be an additional prognostic factor and should be done when assessing the final tumor stage. A positive result should be added to the pTNM classification.
在灌洗液中检测肿瘤细胞可能是实体肿瘤的一个预后因素。因此，342例首次出现肺癌的患者接受了术中胸膜灌洗（灌洗I = 开胸后；灌洗II = 肺癌切除后）。132例患者（38.6%）在灌洗I中发现肿瘤细胞，其中99例在灌洗II中也发现肿瘤细胞。我们在灌洗II细胞学检查中仅在9例中发现肿瘤细胞。I期非小细胞肺癌（n = 164）患者中，灌洗阳性（灌洗I和II，n = 47）时5年累积生存率为25.9%，灌洗阴性（n = 117）时为69.2%（p < 0.05）。此外，我们对23例肺癌患者的无瘤实质进行了组织培养。在16例（69.6%）中，通过组织学和免疫组织学检测到肿瘤细胞。肺癌术中胸膜灌洗中的细胞学肿瘤细胞检测似乎是一个额外的预后因素，在评估最终肿瘤分期时应进行此项检测。阳性结果应添加到pTNM分类中。
