[Transbronchial biopsy of the lung in the diagnosis of peripheral cancer and diffuse-disseminated processes].
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Biomedical subjects
Publications and source records attributed to V A Lebedev.
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The investigation has been performed on 87 corpses of persons of both sex, that died after 60 years of age from the pathology not connected with any diseases in the neck organs. Individual variability in the common carotid artery projection line has been revealed; it conforms, to a certain extent, with the value of the neck index. When the neck is short and thick, the artery position corresponds to the line that runs across the following points: the superior--0.5 cm forward from the mandibular angle, the inferior--0.5 cm medially from the sternoclavicular joint. When the neck index is within the limits 1.71-1.88, it is expedient to draw the classical projection line. When the neck index is within the limits 1.57-1.69, it is possible to determine the projection zone as an elongated rectangle. At the bottom of every side the border of this zone is a straight line drawn between the sternoclavicular joint and the point situating 0.6 cm laterally from the joint, and at the top--the line connecting the top of the mastoid process with the point 1.0 cm behind the mandibular angle.
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The diagnostic value of bronchologic procedures in identification of peripheral cancer of the lung versus tumor's size, endoscopic pattern of bronchial lesion and tumor position with respect to the root of the lung was assessed. Rigid endoscopes and bronchofibroscopes were used in 806 patients with peripheral lung cancer. Bronchoscopic diagnosis of cancer was morphologically confirmed in 64.9% (respiratory endoscope alone--51.3 +/- 3%; bronchofibroscope or combined use of both devices--71.9 +/- +/- 2%).
In this study there is presented a comparative analysis of immediate results after radiotherapy and combined treatment (radio- and chemotherapy) in 174 patients with highly differentiated inoperable lung cancer. The data were provided by participants of a joint investigation in some CMEA member countries (Hungary, USSR, Czechoslovakia) during the period of 1976 to 1980. In the randomized study radiotherapy (a total dose of 60 Gy) was applied in 98 patients, radiotherapy with chemotherapy (methotrexate and 5-fluorouracil) was applied in 76 patients. The comparative analysis showed that the employment of complementary chemotherapy tend to improve the immediate therapeutic effects. In the case of highly differentiated planocellular carcinoma a pronounced positive effect was seen in 48.6% of patients as compared to the 31.2% of those treated with radiotherapy alone. Nevertheless, with respect to survival rate prolongation, these differences are not manifested in favor of the combined method of treatment. After a conservative treatment (radiotherapy and radiotherapy in combination with chemotherapy) of patients with differentiated types of inoperable lung cancer there was a one-year survival rate of 55.7%, 17.27% of the patients survived for 2 years, and 8.55% for 3 years. In radiotherapy applied alone as in the combined method as well, a direct dependence of survival rate prolongation on immediate therapeutical effects was detected. For more than 1 year survived 49 patients (73.1%) out of 67 exhibiting pronounced immediate effects, and for 3 years survived 8 patients out of 9.
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The method suggested for qualitative estimation of the renal and hepatic vessels perfusion before an injection is based on measuring oscillations of the light beam diffused by the organ's surface (the source--a gas laser of continuous action of red spectrum). An absolute photometer protected by a red filter from external effects of light is used as a registrator. Successive injection of the renal and hepatic vessels with different masses and their investigation by means of roentgenography, preparation, carrosion demonstrate a satisfactory effectiveness of the method presented.
An analysis of the results of bronchial tumor biopsy performed in 200 lung cancer patients is reported. Morphological verification proved feasible in 193 of 200 patients. Biopsy and puncturing of the tumor are found to be most advantageous technics for the material take during bronchoscopy. Contrary to biopsy, an efficiency of transbronchial puncturing is not affected by the character of tumor growth and its morphological structure. A combined use of biopsy and puncture makes it possible to increase the percentage of morphologically supported diagnosis of pulmonary cancer. Transbronchial puncturing is also an efficient maneuver for detection of cancer recurrence in the bronchial stump and a residual tumor after conservative therapy. Endoscopic signs of the peribronchial pattern of tumor growth are absolute indications to its puncture.