Clinical relevance of intraoperative pleural lavage cytology in non-small cell lung cancer.
Clinical relevance of intraoperative pleural lavage cytology in non-small cell lung cancer.
复制标题
非小细胞肺癌术中胸腔灌洗细胞学的临床意义。
DOI：
10.1016/j.athoracsur.2006.07.035
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Kotaro Kameyama
中科院分区：
文献类型：
--
作者：
T. Nakagawa;N. Okumura;Yujiro Kokado;K. Miyoshi;Tomoaki Matsuoka;Kotaro Kameyama
背景：据报道，肺癌患者术中胸腔灌洗细胞学检查在检测亚临床胸膜播散方面是有用的。方法回顾性分析1025例手术治疗的非小细胞肺癌患者的临床资料，分析术中胸腔灌洗细胞学检查的临床意义，其中37例（3.6%）患者的胸腔灌洗细胞学检查阳性。患者分为三组：阳性PLC组，27例阳性PLC患者，无恶性胸腔积液或胸膜播散;胸膜播散（PD）组，21例恶性胸腔积液或PD;阴性PLC组，977例阴性PLC或阴性PLC无PD。阳性PLC组的腺癌比例显著高于阴性PLC组（p = 0.014）。PLC阳性组与阴性组的胸膜因素分布有显著性差异（P < 0.001）。阳性PLC组的生存率显著低于阴性PLC组（p = 0.007），尤其是在病理I期（p = 0.001），但显著优于PD组（p = 0.038）。PLC状态被发现是一个重要的独立预后因素在多变量分析（p = 0.016）。CONCLUSIONSSThe本研究表明，术中PLC在早期非小细胞肺癌的临床相关性。术中PLC检查结果应纳入肺癌分期系统。
BACKGROUNDIntraoperative pleural lavage cytology for patients with lung cancer has been reported to be useful in detecting subclinical pleural dissemination. However, this procedure is not necessary for the staging of lung cancer in the current TNM staging system.METHODSClinical records of 1025 patients with non-small cell lung cancer who underwent surgery were retrospectively reviewed and evaluated for the clinical relevance of intraoperative pleural lavage cytology.RESULTSSpecimens of 37 patients (3.6%) were positive for pleural lavage cytology (PLC). Patients were categorized into three groups: positive PLC group, 27 patients with positive PLC without malignant pleural effusion or pleural dissemination; pleural dissemination (PD) group, 21 patients with malignant pleural effusion or PD; negative PLC group, 977 patients with negative PLC or negative PLC without PD. The positive PLC group had a significantly higher ratio of adenocarcinomas than the negative PLC group (p = 0.014). There was a significant difference in distribution of pleural factors between the positive and negative PLC groups (p < 0.001). Survival in the positive PLC group was significantly worse than in the negative PLC group (p = 0.007), especially in pathologic stage I (p = 0.001), but significantly better than in the PD group (p = 0.038). PLC status was found to be a significant independent prognostic factor in the multivariate analysis (p = 0.016).CONCLUSIONSThe present study demonstrates the clinical relevance of intraoperative PLC in early stage non-small cell lung cancer. The result of intraoperative PLC should be involved in the staging system of lung cancer.