In the study, 739 regional lymph nodes from 94 patients with stage I non- small cell lung carcinoma (NSCLC) were studied by immunohistochemical techniques. These lymph nodes contained no metastatic tumor as assessed b...In the study, 739 regional lymph nodes from 94 patients with stage I non- small cell lung carcinoma (NSCLC) were studied by immunohistochemical techniques. These lymph nodes contained no metastatic tumor as assessed by conventional histopatholgy were recut. A series of consecutive sections from the original blocks were immunostained with poly-and monoclonal antibodies to cytokeratins, carcinoembryonic antigen (CEA), and human milk fat globulin membrane antigen (HMFG-2). Single tumor cells or small clusters of tumor cells, not visible on routine examination, were readily detected. The actual number of lymph nodes that contained occult tumor cells was 123 (16.6%) from 53 patients (56.4%). The majority of 102 immunostalned positive nodes were distributed in the hllar (29% ) and peribronchlal (25%) regions. Our data indicate that (1) a series of consecutive sections and immunohistochemistry may greatly Increase the diagnostic yield of occult micrometastases in lymph nodes; (2) the high incidence of occult metastases in NSCLC may be of Importance in relation to their rapid dissemination and high death rates; (3) the high frequencyof occult nodal metastases in NSCLC raises questions in regard to our presently used criteria for staging, prognosis and treatment of ostensibly stage I disease; and (4) perhaps dissections of hllar and peribronchlal nodes will have an Importantly clinical significance in prevention of wide dissemination of tumor cells.展开更多
目的：分析 X 线胸片漏诊隐匿性肺癌的原因，并评价 CT 扫描对隐匿性肺癌的诊断价值。方法选择 X 线漏诊的隐匿性肺癌43例患者为研究对象。通过比较 X 线和 CT 检查结果，分析 X 线漏诊原因。结果43例患者正位 X 线胸片结果显示无异常...目的：分析 X 线胸片漏诊隐匿性肺癌的原因，并评价 CT 扫描对隐匿性肺癌的诊断价值。方法选择 X 线漏诊的隐匿性肺癌43例患者为研究对象。通过比较 X 线和 CT 检查结果，分析 X 线漏诊原因。结果43例患者正位 X 线胸片结果显示无异常，行侧位 X 线胸片检查后，30例患者依然未见异常。CT 扫描证实43例患者全为隐匿性肺癌。CT 扫描对支气管腔内、肺门区肿块及纵隔淋巴结肿大的显示情况优于 X 线胸片检查，差异有统计学意义（P ﹤0.05）。结论 X 线诊断隐匿性肺癌的漏诊率高。对于疑似隐匿性肺癌的患者，有必要行 CT 扫描，及早发现隐匿性肺癌，进一步确定病情，并采取针对性治疗。展开更多
文摘In the study, 739 regional lymph nodes from 94 patients with stage I non- small cell lung carcinoma (NSCLC) were studied by immunohistochemical techniques. These lymph nodes contained no metastatic tumor as assessed by conventional histopatholgy were recut. A series of consecutive sections from the original blocks were immunostained with poly-and monoclonal antibodies to cytokeratins, carcinoembryonic antigen (CEA), and human milk fat globulin membrane antigen (HMFG-2). Single tumor cells or small clusters of tumor cells, not visible on routine examination, were readily detected. The actual number of lymph nodes that contained occult tumor cells was 123 (16.6%) from 53 patients (56.4%). The majority of 102 immunostalned positive nodes were distributed in the hllar (29% ) and peribronchlal (25%) regions. Our data indicate that (1) a series of consecutive sections and immunohistochemistry may greatly Increase the diagnostic yield of occult micrometastases in lymph nodes; (2) the high incidence of occult metastases in NSCLC may be of Importance in relation to their rapid dissemination and high death rates; (3) the high frequencyof occult nodal metastases in NSCLC raises questions in regard to our presently used criteria for staging, prognosis and treatment of ostensibly stage I disease; and (4) perhaps dissections of hllar and peribronchlal nodes will have an Importantly clinical significance in prevention of wide dissemination of tumor cells.
文摘目的：分析 X 线胸片漏诊隐匿性肺癌的原因，并评价 CT 扫描对隐匿性肺癌的诊断价值。方法选择 X 线漏诊的隐匿性肺癌43例患者为研究对象。通过比较 X 线和 CT 检查结果，分析 X 线漏诊原因。结果43例患者正位 X 线胸片结果显示无异常，行侧位 X 线胸片检查后，30例患者依然未见异常。CT 扫描证实43例患者全为隐匿性肺癌。CT 扫描对支气管腔内、肺门区肿块及纵隔淋巴结肿大的显示情况优于 X 线胸片检查，差异有统计学意义（P ﹤0.05）。结论 X 线诊断隐匿性肺癌的漏诊率高。对于疑似隐匿性肺癌的患者，有必要行 CT 扫描，及早发现隐匿性肺癌，进一步确定病情，并采取针对性治疗。
