Problems in the diagnosis of small cell carcinoma of the lungs by fiberoptic bronchoscopy.
Problems in the diagnosis of small cell carcinoma of the lungs by fiberoptic bronchoscopy.
复制标题
纤维支气管镜诊断肺小细胞癌的问题。
DOI：
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发表时间：
1984
影响因子：
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通讯作者：
J. Kleinerman
中科院分区：
文献类型：
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作者：
A. Marchevsky;M. Chuang;A. Teirstein;H. Nieburgs;J. Kleinerman
纤维支气管镜检查（FOB）在内镜活检和刷细胞学检查的辅助下被认为是诊断肺癌的一种有价值的方法。然而，基于从FOB获得的微小标本的肺癌的组织学分类可能是困难的。正确识别肺小细胞癌是特别重要的，因为它的识别通常排除手术。在对770名在纽约西奈山医院（Mount Sinai Hospital）接受FOB活检的患者的回顾中，在确诊的肺癌患者中发现了150例小细胞癌。在这些病例中，由于临床和放射学上肿瘤表现不像小细胞癌，因此进行了后续手术，如斜角淋巴结活检、纵隔镜检查或开胸手术。对这些肿瘤较大组织样本的病理检查提供了以下最终诊断：支气管类癌、腺癌、鳞状细胞癌和小细胞癌合并型。肺组织活检和刷细胞学检查通常可以诊断肺小细胞癌。然而，如果肿瘤的生物学行为对小细胞癌的诊断产生怀疑，则应进行进一步的研究，包括放射性核素扫描，骨髓和其他活组织检查，然后再拒绝患者手术治愈的机会。
Fiberoptic bronchoscopy (FOB) with the aid of endoscopic biopsies and brush cytology is recognized as a valuable approach in the diagnosis of lung cancer. However, histologic classification of lung cancer based on tiny specimens obtained from FOB can be difficult. Correct identification of small cell carcinoma of the lung is especially important because its recognition usually precludes surgery. In a review of 770 patients who underwent FOB biopsies at The Mount Sinai Hospital, New York, in individuals with proven lung cancer 150 instances of small cell carcinoma were encountered. In four of these instances subsequent surgery, such as scalene node biopsy, mediastinoscopy, or thoracotomy, was performed because clinically and radiologically the tumors did not behave as small cell carcinomas. Pathologic examination of larger tissue samples from these neoplasms provided the following final diagnoses: bronchial carcinoid, adenocarcinoma, squamous cell carcinoma, and small cell carcinomas-combined type. Analysis of the FOB biopsies and brush cytology usually permit diagnosis of small cell carcinoma of the lung. However, in instances where the biologic behavior of a tumor casts doubt on the diagnosis of small cell carcinoma, further studies should be performed, including radionuclide scans, and bone marrow and other biopsies before denying the patient a chance of surgical cure.