Ringbaek T J, Borgeskov S, Lange P, Viskum K
Bispebjerg Hospital, lungemedicinsk afdeling P.
Ugeskr Laeger. 1998 Jan 5;160(2):166-9.
During the last 50 years, the 5-year survival of lung cancer patients has been unchanged at 5%. As the prognosis for patients with operable nonsmall cell lung cancer (NSCLC) is much better, the diagnostic examination of tumour suspicious lesions with secondary judgement of operability in NSCLC is an important subject. This study focuses on the diagnostic process. During the years 1991-1993, 467 consecutive patients with pulmonary tumour suspicious lesions were prospectively followed at the Department of Pulmonary Medicine and the Department of Thoracic Surgery, Bispebjerg Hospital. In 40% of the patients, the diagnostic delay was longer than 30 days. Fiberbronchoscopy and fine needle biopsy were the most important diagnostic tests with an accuracy of approx. 90% for both central and peripheral lesions. Benign lesions comprised 19% of all, while the prevalence of squamous cell carcinoma, adenocarcinoma, small-cell carcinoma and large-cell carcinoma was respectively 21%, 26%, 15% and 18% of the malignant infiltrates. Histological diagnosis was not achieved in 104 patients. Histological diagnosis was achieved in most patients, but the diagnostic process was slow. A faster diagnostic process is to be aimed for and can, hopefully, be achieved by accomplishing diagnostic standards as just proposed by the Danish Lung Cancer Group.
在过去50年里，肺癌患者的5年生存率一直维持在5%不变。由于可手术的非小细胞肺癌（NSCLC）患者的预后要好得多，因此对NSCLC中可疑肿瘤病变进行诊断检查并对手术可行性进行二次判断是一个重要课题。本研究聚焦于诊断过程。1991年至1993年期间，比斯佩比约格医院胸内科和胸外科对467例连续性肺肿瘤可疑病变患者进行了前瞻性随访。40%的患者诊断延迟超过30天。纤维支气管镜检查和细针活检是最重要的诊断检查，对中央型和周围型病变的准确率约为90%。良性病变占所有病变的19%，而鳞状细胞癌、腺癌、小细胞癌和大细胞癌在恶性浸润中的患病率分别为21%、26%、15%和18%。104例患者未获得组织学诊断。大多数患者获得了组织学诊断，但诊断过程缓慢。应追求更快的诊断过程，有望通过达到丹麦肺癌小组刚刚提出的诊断标准来实现。
