Ninane V, Bosschaerts T
Cliniques de Pneumologie et de Chirurgie Thoracique, Hôpital Saint-Pierre, Bruxelles.
Rev Mal Respir. 1998 Jun;15(3 Pt 2):351-62.
Bronchoscopy plays a major role in the histological diagnosis of stage III lung cancer and the choice among bronchoscopic techniques may very according to the central or peripheral localization of the lesion. To obtain the histological diagnosis, percutaneous needle aspiration and bronchoscopic procedures are rather complementary. In staging of bronchogenic carcinoma, bronchoscopy may confirm neoplastic involvement of the main carina (T4), involvement within 2 cm of the main carina (T3) or involvement of mediastinal nodes (N2 or N3) by the use of transbronchial needle aspiration. Extension of lung cancer to intrathoracic lymph nodes is better assessed by mediastinoscopy. The use of thoracoscopy in staging has been increasing in particular in cases of concomitant pleural effusion.
支气管镜检查在Ⅲ期肺癌的组织学诊断中起着重要作用，支气管镜检查技术的选择可能因病变的中央或外周定位而异。为了获得组织学诊断，经皮针吸活检和支气管镜检查程序相当互补。在支气管源性癌的分期中，支气管镜检查可通过经支气管针吸活检来确认主支气管隆突（T4）、主支气管隆突2cm范围内（T3）的肿瘤累及或纵隔淋巴结（N2或N3）的累及。通过纵隔镜检查能更好地评估肺癌向胸内淋巴结的扩展。在分期中，尤其是伴有胸腔积液的病例，胸腔镜检查的应用一直在增加。
