肺癌术中胸腔冲洗液细胞学的临床意义

The clinical value of pleural lavage cytology during operation for lung cancer

目的 研究术中胸腔冲洗液细胞学检测对肺癌患者的预后价值。方法 无恶性胸腔积液的 10 0例肺癌患者 ,剖胸后及术毕胸膜腔冲洗 ,冲洗液行病理细胞学检查 ,术后患者随访。结果 冲洗液细胞学检测 :术前阳性 8例 ,术后阳性 5例。 3年生存率随访 :冲洗液细胞学阳性者为 2 0 % ,阴性者为 6 0 %。冲洗液阳性的相关因素包括 :病理分期、细胞类型、肿瘤大小、胸膜侵犯程度。结论 术中胸膜腔冲洗液细胞学检查可提示胸膜腔的微转移 ,是一个重要的预后因素。

Objective To study the prognostic value of pleural lavage cytology during operation in patients with lung cancer. Methods One hundred patients without pleural effusion received lobectomy or pneumonectomy for lung cancer. Lavage was performed before lung manipulation and after resection and was cytologically evaluated. Every case was followed up. Results Eight cases had positive cytologic findings before resection, While five cases were positive after resection . The 3-year survival rate was 20% in cytology positive cases, and was 60% in cytology negative cases. The positivity of pleural lavage cytology was related to the pathologic stage, cytologic type, tumor size and degree of pleural extension of the tumor. Conclusions The examination of pleural lavage cytology during operation can indicate the pleura micrometastasis. Positive cytology may be an important prognostic factor for the patients with lung cancer.