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目的 探讨术前无胸腔转移表现的食管癌病人手术时胸腔冲洗液细胞学检查 (PleuralLavageCytology ,PLC)的阳性率及其相关因素。方法 10 9例食管癌病人在行根治术时 ,分别于开胸后未作任何胸内操作前 (简称前次 )及切除病变断端食管吻合完毕后 (简称后次 )两种不同的时机冲洗胸腔 ,并用一次性病变细胞采集器收集细胞 ,HE染色 ,光镜观察。结果 前、后两次PLC阳性率分别为 72 .48% (79/ 10 9)、43 .12 % (4 7/ 10 9)。PLC阳性与肿瘤的大小、部位、分化程度、浸润深度等均无相关性 ,而与冲洗时机的不同有明显相关。结论 选择开胸后未作任何胸内操作前进行PLC检查更为合理 ,行食管癌根治术同时多次反复进行胸腔冲洗可以减少脱落癌细胞数目。PLC检查结果可以作为食管癌的一个辅助分期和预后因素 ,同时也可作为一个术后辅助治疗的选择指标。
Objective To investigate the positive rate of Pleural Lavage Cytology (PLC) and its related factors during operation in esophageal cancer patients without thoracic metastasis. Methods A total of 109 patients with esophageal cancer undergoing radical operation were rinsed with two different timing before thoracotomy without any intrathoracic operation (referred to as the previous time) and esophageal anastomosis after resection of the diseased part of the esophagus (referred to as the second time) Thoracic cavity, and collect the cells with a disposable lesion cell harvester, HE staining, light microscopy. Results The positive rates of PLC before and after the two were 72.48% (79/109) and 43.12% (47/9), respectively. PLC positive and tumor size, location, degree of differentiation, depth of invasion were no correlation, but with the timing of the flushing are significantly related. Conclusion It is more reasonable to select PLC before thoracotomy without any intrathoracic operation. Concurrent esophagectomy with repeated thoracic irrigation can reduce the number of cancerous cells. PLC test results can be used as a secondary esophageal cancer staging and prognostic factors, but also can be used as a postoperative adjuvant treatment of choice indicators.