肺癌患者胸腔冲洗液细胞学检查对预后的预测价值  

The Prognostic Value of Examining Pleural Lavage Cytology During Surgery for Lung Cancer Patients

作　　者：王传庆[1] 郝蓉美 刘景亮[1] 陈姿[1] 金明华[1] 王伟[1] 

机构地区：[1]山东省胸科医院胸外科,济南市250013

出　　处：《中国肿瘤临床》2009年第18期1027-1030,共4页Chinese Journal of Clinical Oncology

基　　金：山东省卫生厅立项科研基金资助(编号:1999-2096)

摘　　要：目的:证明无胸水肺癌患者胸腔内存在游离癌细胞,探讨其相关因素及对预后的预测价值。方法:对172例无胸水肺切除肺癌患者进行了胸腔冲洗液细胞学检查(PLC)。于开胸探查前冲洗,收集后立即细胞学检查。结果:阳性47例(27.3%),与细胞类型、原发肿瘤、淋巴结转移、胸膜受侵程度有关,并具有腺癌>鳞癌、T_4>T_3>T_2>T_1、N_3>N_2>N_1>N_0、P_3>P_2>P_1>P_0、Ⅲ>Ⅱ>Ⅰ的特点。PLC阳性患者的5年生存率为26.1%,阴性为49.2%。结论:无胸水肺癌患者胸腔内有游离癌细胞存在,与细胞类型、T、N、P因素相关,PLC结果是一项重要的预测患者预后的指标。Objective： TO detect free carcinoma cells in the pleural cavity of lung cancer patients without pleural effusion, to evaluate the correlation between cytological findings and histopathological factors, and to assess the predictive value of pleural lavage cytology （PLC）. Methods： From June 1, 1999, to May 31, 2002, 172 （156 males and 16 females） patients with lung cancer were enrolled in the study. Pleural lavage fluid was collected after thoracotomy and evaluated immediately for its cytological characteristics. All patients were followed up until May 31, 2007. Results： Cytology results showed malignant cells in 47 （27.3%） of the 172 patients. The incidence of positive results was correlated with histological type （adenocarcinoma〉squamous cell carcinoma）, primary tumor size （T4〉T3〉T3〉T1）, lymph node status （N3〉N2〉N1〉N0）, visceral pleural status （P3〉 P2〉P1〉P0） and postoperative TNM staging （Ⅲ 〉 Ⅱ 〉 Ⅰ ）. The 5-year survival rate was 26.1% in patients with positive PLC and 49.2% in patients with negative PLC. Conclusion： Free carcinoma cells may be present in the pleural cavity of patients with lung cancer without accompanying pleural effusion and may be correlated with T, N and P factors. PLC is important for ascertaining prognosis in patients with lung cancer.

关 键 词：支气管肺癌 细胞学检查 胸腔冲洗液 预后 

分 类 号：R734.2[医药卫生—肿瘤]