食管良恶性狭窄及瘘的带膜内支架介入治疗

目的：研究应用带膜的镍钛合金金属内支架治疗食管的良恶性狭窄。方法：共60例患者,不能手术晚期食管癌19例,食管癌放疗后引起的食管狭窄20例,手术后吻合口狭窄18例,手术后吻合口瘘2例,腐蚀性食管炎1例,4例合并食管-气管瘘或食管-纵隔瘘。所用器械包括：6F猎人头导管,0.035Cun长1.8m交换导丝,食管球囊导管,支架推送器和50-120mm镍钛合金属支架。全部在电视透视下进行,局部口咽部麻醉。结果：全部病例均获成功,其中一例患者因狭窄位置较高,支架置入后48小时取出,术后进食良好。结论：带膜的镍钛合金金属内支架对食管的恶性狭窄进行姑息性治疗是提高患者生存质量安全有效的方法;对手术后吻合口瘘与狭窄和食管-气管瘘或食管-纵隔瘘起到了较好的治疗作用。     

Clinical benefit of bronchial arterial infusion chemotherapy to pulmonary metastasis from colorectal cancer--report of two cases

Case 1: A 60-year-old woman with sigmoid colon cancer and multiple lung metastases developed dyspnea 34 months after sigmoidectomy and following systemic chemotherapy. Chest X-ray revealed left atelectasis and obstruction of the left main bronchus by lung metastasis, and stenosis of the right main bronchus was also suspected. Bronchial arterial infusion of CDDP, 5-FU and MMC relieved the atelectasis and dyspnea. The left bronchus remained patent for 12 months. Case 2: A 70-year-old man who had a pulmonary recurrence of rectal cancer suffered from hemoptysis and dyspnea, which had improved with systemic chemotherapy but then become exacerbated again. Bronchoscopic examination revealed intraluminal bleeding from a metastatic tumor. The symptoms were relieved after bronchial arterial infusion of CDDP, 5-FU and MMC. The diameter of the treated tumor was reduced by 15%. Hemoptysis was negligible until he died 8 months later. Bronchial arterial infusion chemotherapy for pulmonary metastasis from colorectal cancer is clinically beneficial, especially for patients with life-threatening respiratory symptoms like airway obstruction or intraluminal bleeding.     

气管支气管树腺样囊性癌MSCT表现

  目的  观察分析气管支气管树腺样囊性癌（adenoid cystic carcinoma,ACC）的MSCT表现,以期提高对该病的认识。  方法  回顾性分析和总结天津医科大学肿瘤医院2004年4月至2013年4月经组织病理证实的19例原发气管支气管树腺样囊性癌的MSCT表现。  结果  19例中气管病变7例,段及以上支气管病变10例,周围型病变2例;腔内外生长型15例（79%）,腔内生长型2例（11%）。气管ACC有明显的沿气管黏膜下浸润延伸趋势,表现为气管壁弥漫环周增厚2例,移行状增厚3例;10例段及以上支气管ACC均表现为腔内外型肿物,8例病变相邻支气管腔内可见息肉样影隆起或突入,7例腔外部分大于腔内。13例增强检查中3例无强化,5例轻度强化,4例中度强化,1例明显强化。  结论  气管支气管树腺样囊性癌MSCT表现具有一定特点,CT可定性诊断,但明确诊断需依靠病理。      

食管癌术后吻合口狭窄扩张后再狭窄的影响因素分析

目的分析食管癌术后吻合口狭窄扩张治疗后再狭窄的危险因素。方法将94例食管癌术后吻合口狭窄行扩张治疗患者作为研究对象,收集人口学特征、术前临床特征、扩张方法以及扩张后结果等资料并建立数据库,所有患者术后随访6个月,根据随访期内是否再发吻合口狭窄分为再狭窄组和无再狭窄组,采用单因素和多因素Logistic回归分析法,探讨扩张治疗后再狭窄的影响因素。结果随访期间,5例出现吻合口肿瘤复发、2例失访而剔除研究,其余87例患者中再发狭窄51例(再狭窄组),无再发狭窄36例(无再狭窄组)。单因素分析结果显示,吻合口位置、扩张方法、首次扩张后吻合口直径、有无出血以及进食时间可能与食管癌术后吻合口狭窄扩张后再狭窄有关(P﹤0.05)。多因素Logistic回归分析结果显示,吻合口位于气管分叉上方、首次扩张后吻合口直径﹤12 mm是食管癌术后吻合口狭窄扩张后再狭窄的危险因素,而扩张后出血以及术后12 h内进食是食管癌术后吻合口狭窄扩张后再狭窄的保护因素(P﹤0.05)。结论食管癌术后吻合口狭窄首次扩张治疗应尽量将吻合口直径扩张至12 mm以上,尤其是对于高位吻合口,在不引起大量出血的前提下,应鼓励早期进食。     

恶性复杂中央气道病变的气管镜介入治疗

背景与目的复杂气道狭窄是临床处理的难题,尤其是恶性气道肿瘤。本研究旨在总结112例恶性复杂气道狭窄气管镜介入治疗的效果,以探讨热消融、冷冻等不同方法在患者中的应用价值。方法回顾性分析112例恶性中央型气道病变患者,均累及隆突附近的气管下段、双侧支气管开口至少两个部位的病变,年龄22岁-90岁,其中鳞癌（squamous carcinoma, SQ）55例、腺癌（adenocarcinoma, AD）16例、腺样囊性癌（adenocystic carcinoma, ACC）15例、转移性癌（metastasis tumor, MT）10例、小细胞肺癌（small cell lung carcinoma, SCLC）及混合癌（mixted carcinoma, MC）各8例,均在硬质气管镜或电子气管镜下进行氩等离子体凝固（argon plasma coagulation, APC）、电圈套器、二氧化碳（CO2）冷冻等气管镜下介入治疗。结果112例恶性气道病变患者进行了460例次气管镜治疗,各组均以冷冻和APC最常用,MT中还有内支架置入。球囊导管扩张主要用于ACC和AD,圈套器和粒子植入常用于SCLC。术前气管狭窄以MT组最重,同一癌症中SQ及ACC支气管的阻塞程度均重于气管。术前MC、MT和SCLC三组卡氏体能状态评分（Karnofsky performance score, KPS）明显降低,而气促评分却明显升高。经多种方法综合治疗后,除MC外,其他五组气管和支气管狭窄均有明显改善。除AD组外,其他五组KPS均明显升高、气促评分均明显下降。术后随访,患者总的生存时间是15个月,中位生存时间10个月。其中以ACC（28.4个月）和AD（21.7个月）的中位生存时间最长,而以SCLC（8.9个月）和MC（7.4个月）最短。结论针对累及多个部位的恶性中央型气道病变,应采取以冷冻和APC为主的联合治疗方法,无论对气管还是支气管,均有良好的治疗作用,快速、安全,值得推广。     

气管狭窄的放射治疗

目的:探讨气管狭窄行放射治疗的可行性和临床疗效.方法:对11例晚期恶性肿瘤所致气管狭窄的危重患者行姑息放疗.结果:所有患者在放疗过程中无死亡,呼吸困难均在1～2周内缓解,8例生存38～110天,平均74天,余3例随访6～20个月仍生存,无呼吸困难.结论:放射治疗可以作为缓解晚期气管狭窄、提高生活质量的一种有效方法.     

支气管镜介入治疗肺肉瘤

背景与目的肺肉瘤为发生于肺部少见的软组织恶性肿瘤,常规治疗首选手术。本研究旨在探讨采用支气管镜介入治疗的效果。方法回顾性分析2008年11月-2014年7月我院收治的16例肺肉瘤患者,平均年龄（53.1±5.4）岁。所有患者首次治疗均选用全凭静脉麻醉下硬质气管镜检查,发现肿瘤后行支气管镜介入治疗。再次检查时行电子支气管镜检查。结果16例患者中肉瘤样癌10例,纤维肉瘤和肉瘤各2例,纤维粘液性肉瘤和梭性细胞型滑膜肉瘤各1例。周围型11例（占68.8%）,主要位于右上叶和左下叶肺内;中央型5例（31.2%）。位于肺内者以混合型多见（9/11,82%）,原发性较多（9/11,82%）;而位于大气道者以管内型多见（9/16,56%）,转移性较多（11/16,69%）。支气管镜介入治疗后4例全肺不张均缓解,7例肺叶不张3例完全缓解,部分缓解和无效各2例。患者气道阻塞、卡氏体力状态（Karnofsky performance status, KPS）和气促评分均有明显改善。结论支气管镜介入治疗能快速、有效地清除气道内肿瘤,缓解气道梗阻,改善症状。     

A case of pyloric or antral malignant stenosis treated with arterial infusion chemotherapy and palliative therapy--self-expandable metal stents through gastrostomy

The patient is a 62-year-old woman. She had type 3 advanced stomach cancer that was judged to have caused complete stricture of the pylorus, and to be inoperable. She received percutaneous endoscopic gastrostomy (PEG) for decompression. She also received arterial infusion chemotherapy with 5-FU, methotrexate (MTX) and cisplatin (CDDP). As a result, the pylorus stricture was reduced somewhat. We tried a self-expandable metal stent (EMS) after obtaining informed consent. A guide-wire passed in gastrostomy was introduced to the pyloric or antral stenosis manually under x-ray fluoroscopy and endoscopy. Next the EMS was introduced to the position of the stenosis over the positioned guide-wire, and then it was released. The EMS did not migrate after placement and the quantity of meals she could consume was considerably improved. She could take meals for three months after stenting. Bypass procedure is often performed for patients with advanced stomach cancer with pylorus stricture, but we thought we could help the patient maintain a good quality of life (QOL) by pylorus stenting in combination with arterial infusion chemotherapy.     

Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer: which to choose?

The degree of healing and damage of the bronchial wall after photodynamic therapy, Nd-YAG laser and electrocautery for intraluminal early-stage cancer have been analysed. Review of the bronchoscopy reports and follow-up histology specimens of twenty-nine patients treated bronchoscopically with curative intent for their intraluminal tumor have been performed. Seventeen patients had been treated with bronchoscopic electrocautery (BE) only, six with photodynamic therapy (PDT) and six with Nd-YAG laser. Bronchial wall scarring seen during follow-up bronchoscopy was scored and subepithelial fibrosis were histologically evaluated using Alcian blue staining, Azan staining and polarised light. After BE, prominent airway scarring was seen in five patients (29%), with significant stenosis (>50% lumen) in one of these cases. Prominent scarring and significant stenosis were found in four (67%), after PDT. In five (83%) after Nd-YAG laser prominent scarring was found, one patient had significant stenosis. In three cases, two after BE and one after PDT, subepithelial tissue in the follow-up biopsies was insufficient for proper histologic examination. In the remaining biopsy specimen only one (7%) showed a moderate or excessive amount of fibroblasts after BE, whereas for PDT and Nd-YAG this was found in three (60%) and four patients (67%), respectively. Excessive matrix was found in none of the biopsies after BE, in two (40%) after PDT and in three (50%) after Nd-YAG laser. Compact collagen formations were seen in two (12%) biopsies after BE, in two (40 and 33%) after PDT and Nd-YAG, respectively. Compared to electrocautery, more airway scarring and more subepithelial fibrosis were seen after treatment with PDT and Nd-YAG laser. These findings, especially regarding PDT, is in contrast to the assumption that PDT is selective and may be important in the choice of treatment for patients with early stage cancer.     

氩气刀联合冷冻治疗恶性肿瘤引起中央气道狭窄的临床疗效

目的:观察电子支气管镜下氩气刀联合冷冻治疗恶性肿瘤所致中央气道狭窄及阻塞的临床疗效。方法:对39例恶性肿瘤导致中央气道阻塞患者,经电子支气管镜下进行氩气刀及冷冻治疗,观察疗效和并发症的发生率。结果:39例患者共进行51次治疗,近期一次介入治疗后完全有效24例（61.5%）、部分有效12例（30.8%）、轻度有效2例（5.1%）及无效1 例（2.6%）,39 例患者中,术后 3例出现痰血,无气胸、纵隔气肿、大咯血等严重并发症。大部分患者呼吸困难指数分级由Ⅳ-V级改善到0-Ⅱ级。结论:支气管镜下氩气刀联合冷冻治疗恶性肿瘤引起的中央气道阻塞疗效显著,对恶性肿瘤引起的中央气道狭窄阻塞是非常有效的姑息治疗手段。     

Ultrasound directed extrahepatic bile duct intraluminal brachytherapy.

Intraluminal brachytherapy with a transcatheter Iridium-192 (Ir-192) wire, as a method to deliver a boost to patients with tumors of the extrahepatic bile ducts, has been well described. A major limitation of current imaging techniques is the inability to accurately define the proximal, distal, and most importantly the lateral extent of the tumor. We have found endoluminal ultrasound, which to this date has been used primarily to measure arterial wall layers, can successfully determine tumor volume in the bile ducts. The small diameter of these ultrasound probes allows easy insertion into a biliary duct drainage tube. Given the uncertainties in the determination of tumor size in the bile ducts, ultrasound is an ideal method by which to obtain the measurements. We present a case of recurrent islet cell carcinoma treated with external beam radiation therapy and an Ir-192 intraluminal brachytherapy boost in which the ultrasound probe was used to determine the tumor volume and response to therapy.     

Frontiers in interventional endoscopy

Digestive endoscopy, including endoscopic ultrasound, plays actually an important role in oncology concerning early diagnosis, tumor staging, and therapeutic procedures. Indeed, improvement of endoscope and dedicated accessories allow to increase applications of therapeutic endoscopy in oncologic indications : curative resection of early carcinoma ant submucosa tumor ; palliative treatment of tumoral bilio-digestive obstruction. Possibilities to resect sessile or flat polyps allow to treat curatively well-differentiated carcinoma without infiltration of the muscularis mucosae, the risk of lymph nodes invasion being null in this cases. In case of invasion of muscularis mucosae, this risk is inferior to 1% for colorectal cancer when submucosal invasion do not exceed 1000 microm but this risk is between 6 and 22% in case of oeso-gastric carcinoma invading the third part of the submucosa. Mortality of endoscopic resection was null in almost published series. Morbidity was 15-20% for colorectal resection with 5-6% of severe complications and up to 23% after oesophageal tumor ablation. Moreover, improvement of echoendoscope dedicated to therapeutic procedures allow from now to achieve non-anatomic pancreatic or biliary drainage through the gastric wall when the retrograde route is not suitable (whipple resection, duodenal stricture) or when drainage of the left hepatic lobe is difficult via the retrograde approach. The aim of this technique is to realize an anastomosis between the left hepatic duct and the stomach. Permanence of this fistula is ensured by insertion of one or two stent. Efficacy and safety of this procedure were recently retrospectively evaluated with a technical success in 91% of cases. Therapeutic endoscopy made many progress during the last years and development of new generation of endoscope and accessories would allow a real endoluminal surgical approach for superficial tumor, bilio-digestive anastomosis or gastro-enteroanastomosis by example.     

恶性肿瘤继发双侧输尿管梗阻的腔内治疗

目的分析腔内泌尿外科技术治疗恶性肿瘤继发双侧输尿管梗阻。方法回顾性分析43例(70例次)恶性肿瘤继发双侧输尿管梗阻患者应用腔内技术治疗的疗效。在治疗的70例次中,应用逆行输尿管镜置管术38例次,微创经皮肾穿刺造瘘术(MPCN)24例次,顺行输尿管镜置管术8例次。结果43例患者术后平均随访12个月。逆行输尿管镜置管术、MPCN术和顺行输尿管镜置管术的治疗成功率分别为50.0%(19/38)、100.0%(24/24)和62.5%(5/8)。肿瘤侵袭输尿管开口(13/38)和严重腔外梗阻(6/38)是导致逆行输尿管镜置管术失败的主要原因;严重腔外梗阻(3/8)是导致顺行输尿管镜置管术失败的主要原因;术后肾造瘘管脱出(11/19)是限制MPCN应用的主要因素。结论腔内技术治疗恶性输尿管梗阻是安全、有效的。逆行输尿管镜置管术是本病的首选治疗方法,但对于肿瘤侵袭输尿管开口或严重腔外梗阻患者,可根据梗阻的部位和程度选用MPCN术或顺行输尿管镜置管术。     

Palliation of advanced/recurrent esophageal carcinoma with high-dose-rate brachytherapy

PURPOSE: The aim was to assess the improvement in swallowing status, complication rate, and overall survival. PATIENTS AND METHODS: Fifty-eight patients with advanced/recurrent esophageal carcinoma were treated for palliation with high-dose-rate intraluminal brachytherapy (HDR-ILRT) with a remote afterloading microSelectron unit (192Ir source) with or without external radiation from November 1994 to May 2000 at the Tata Memorial Hospital. The mean age was 64 years. The mid-third of the esophagus was involved in 38 patients (66%). The group was comprised of 37 previously untreated patients (29 with < or = 50% Karnofsky performance status and old age, 4 with metastatic disease, and 4 with second primary esophageal lesions) and 21 patients with post-treatment recurrent tumors. Thirty-eight patients (65%) received intraluminal brachytherapy alone, whereas the remaining 20 patients (35%) received a combination of external and intraluminal radiation therapy. All patients received 2 fractions of HDR-ILRT 1 week apart with 600 cGy per fraction at 1 cm off axis. RESULTS: Overall improvement in swallowing status was seen in 22 patients (48%), and 24 (41%) maintained pretreatment swallowing status. Median dysphagia-free survival was 10 months. Overall complication rates were 30%, with stricture seen in 9 patients (15%), ulceration in 6 (10%), and tracheo-esophageal fistula in 3 patients (5%). Complication rates were higher in the post-treatment group (38%) than in the previously untreated group (27%) (p = 0.29). The median overall survival for the entire group was 7 months. Median survival was better, although not significantly, for the previously untreated cohort: 7.8 months vs. 6 months for the post-treatment group (p = 0.77). CONCLUSION: HDR-ILRT brachytherapy achieves good palliation with acceptable complications in advanced/recurrent esophageal carcinoma.     

Virtual bronchoscopy: comparison of different surface rendering models

The aim of this study was to compare different representation models of surface-rendered virtual bronchoscopy. 10 consecutive patients with inoperable primary lung tumors underwent thin-section spiral computed tomography. The structures of interest, the tracheobronchial system and anatomical and pathological thoracic structures were segmented using an interactive threshold interval volume-growing segmentation algorithm and visualized with the aid of a color-coded surface rendering method. For virtual bronchoscopy, the tracheobronchial system was visualized using a triangle-surface rendering model, a shaded-surface rendering model and a transparent shaded-surface rendering model. The triangle-surface rendering model allowed optimum detailed spatial representation of the dimensions of extraluminal anatomical and pathological mediastinal structures. As the lumen of the tracheobronchial system was less well defined, the rendering model was of limited use for depiction of the airway surface. The shaded-surface rendering model facilitated an optimum assessment of the airway surface, but the mediastinal structures could not be depicted. The transparent shaded-surface rendering model provides simultaneous adequate to optimum visualization and assessment of the intraluminal airway surface and the extraluminal mediastinal structures as well as a quantitative assessment of the spatial relationship between these structures. Fast data acquisition with a multi-slice detector spiral computed tomography scanner and the use of virtual bronchoscopy with the transparent shaded-surface rendering model obviate the need for time consuming detailed analysis and presentation of axial source images by providing improved the diagnostic imaging of endotracheal and endobronchial diseases and offering a useful alternative to fiberoptic bronchoscopy.     

新辅助放化疗联合手术治疗ⅠB2~ⅡA2期子宫颈癌临床预后因素分析

背景与目的：探讨Ⅰ_B2～Ⅱ_A2期子宫颈腺癌与腺鳞癌经新辅助放化疗联合手术治疗后的生存及复发情况,并分析其预后影响因素。方法：收集蚌埠医学院第一附属医院2005年4月—2011年10月50例Ⅰ_B2～Ⅱ_A2期患者的临床病理资料。患者均接受广泛全子宫切除+盆腔淋巴结清扫术,且术前均接受1次静脉化疗,宫颈肿瘤直径大于等于6 cm,给予阴道腔内放疗1次。回顾分析患者的生存及复发情况,探讨其预后影响因素。结果：50例Ⅰ_B2～Ⅱ_A2期子宫颈腺癌和腺鳞癌患者中,随访期内死亡15例,2年和5年无进展生存率分别是80.12%和72.24%,中位无进展生存时间为68个月;2年和5年累积总生存率分别是95.38%和73.56%,中位总生存时间为80个月。单因素分析显示,盆腔淋巴结转移、宫颈间质浸润、宫旁浸润和新辅助放化疗后肿瘤最大直径缩短小于3 cm的患者预后较差(P<0.05),而年龄、术后放化疗、淋巴管间隙受累分期、FIGO分期、是否保留卵巢和病理类型与预后无明显相关性(P>0.05)。多因素COX回归分析结果显示,盆腔淋巴结转移和放化疗后肿瘤直径缩小是宫颈腺癌和腺鳞癌的独立预后影响因素。结论：新辅助放化疗联合手术治疗提高了Ⅰ_B2～Ⅱ_A2期宫颈腺癌和腺鳞癌手术切除率,而盆腔淋巴结转移及放化疗后宫颈肿瘤最大径消退程度是宫颈腺癌和腺鳞癌的独立预后因素。     

食管贲门癌切除术黏膜层单层吻合法疗效分析

目的探讨食管、胃及空肠黏膜单层吻合法预防吻合口瘘、吻合口狭窄及返流性食管炎的效果.方法 1996年3月～2002年8月手术治疗食管癌235例,贲门癌195例,采用食管-胃及空肠黏膜延长、黏膜单层缝合法.结果术后10 d X线吞钡照片示钡剂通过顺畅,吻合口直径1.5～2 cm.术后随访1年,吞咽顺利,未见吻合口狭窄.结论该术式吻合口径宽,对预防吻合口瘘、狭窄及返流性食管炎效果显著,是食管及胃肠吻合较为理想的方法.     

Short-course palliative radiotherapy for airway stenosis in non-small cell lung cancer

Background: The majority of patients with non-small cell lung cancer have inoperable disease that is already too advanced for radical treatment at the initial diagnosis. But patients who suffer from symptoms caused by intrathoracic tumor often require palliative treatment to relieve the symptoms. We investigated, retrospectively, the outcome of short-course palliative radiotherapy for airway stenosis in non-small cell lung cancer. Methods: Between October 1997 and June 2001, 24 patients were treated by palliative radiotherapy to relieve airway stenosis caused by intrathoracic tumor. The short-course radiotherapy consisted of a total dose of 30 Gy given in ten fractions over 2 weeks. The effect of treatment was assessed by improvement of radiographic findings. The duration of palliation and this duration as a percentage of the remaining survival time were also investigated. Results: Palliation of airway stenosis was achieved in 13 (54.2%) patients. The time until palliation was achieved ranged from 11 to 44 days (median, 24 days). The duration of palliation ranged from 44 to 351 days (median, 116 days). In the palliated patients, the median survival time was 192 days, while that of the non-responders was 43 days. The duration of palliation as a percentage of the remaining lifetime ranged from 41% to 96% (median, 66%). Conclusions: Short-course palliative radiotherapy of 30 Gy in ten fractions over 2 weeks achieved good palliation without severe acute toxicities in over half of the patients. It is suggested that, in the palliated patient, the airway can be, potentially, maintained over the long term. Received: March 7, 2002 / Accepted: May 24, 2002 This paper was presented at the 13th annual meeting of the Japanese Society for Therapeutic Radiology and Oncology, at Niigata, Japan, November 10–12, 2000. Correspondence to:K. Nihei     

The curative potential of intraluminal bronchoscopic treatment for early-stage non-small-cell lung cancer

Bronchoscopic treatment modalities such as lasers, electrocautery, cryotherapy, photodynamic therapy, and brachytherapy are potentially curative for patients with very-early-stage non-small-cell lung cancer (NSCLC) in the central airways. Previously, studies had primarily focused on the effectiveness of surgery, surgical bronchoplasty, and photodynamic therapy. The cure rate of intraluminal bronchoscopic treatment is strongly related to the patient's functional status and tumor stage. Intraluminal tumors are curable bronchoscopically when they are accessible to the fiberoptic bronchoscope, strictly intraluminal, and superficial with visible proximal and distal tumor margins. Early-stage cancer infiltrating deeper into the bronchial wall may already harbor metastases to the regional lymph nodes; hence, curative intraluminal treatment is not feasible. The use of new diagnostic tools (eg, high-resolution computed tomography, autofluorescence bronchoscopy, and endobronchial ultrasound) may improve staging to select the category of patients in whom intraluminal bronchoscopic therapy with curative intent is appropriate. An accurate intraluminal tumor staging will improve our ability to exploit the curative potential of many bronchoscopic techniques for complete tumor eradication in patients with very-early-stage intraluminal NSCLC in their central airways. The use of bronchoscopic treatment as a less morbid alternative than surgical resection will benefit patients most when tumor is detected at the earliest stage possible.     

Bronchoscopic treatment of patients with intraluminal microinvasive radiographically occult lung cancer not eligible for surgical resection: a follow-up study

Bronchoscopic treatment (BT) has a curative potential for patients with intraluminal microinvasive radiographically occult lung cancer (ROLC). We report the long-term follow-up in a group of 32 patients, ineligible for surgery, in whom ROLC was diagnosed and treated with BT. Tumors were strictly 相似文献