Abstract
The incidence of tumor cells in pleural effusions, their disappearance after treatment and their relationship to survival time were studied in 148 cases (including 93primary lung cancer and 55 metastatic pleurisy cases).
The positive rate of tumor cells in pleural effusion was 73%, while the negative rate after treatment was 65% in primary pleurisies, and 80% in metastatic pleuritic cases. The effects of systemic chemotherapy and thoracocentesis or tube thoracostomy with local instillation of anti-cancer drugs were also evaluated. Tube thoracostomy and local instillation of anticancer agents and talc were more effective than thoracocentesis or systemic chemotherapy alone.
We have performed contrast thoracography after pleurodesis through the intrathoracic drain. The border of the adhesion was verified by change of position under fl uoroscopy. It is thought to be the best method for confirming the extent of adhesion after pleurodesis and deciding the most suitable time for removing the intrathoracic drain.
Also in this study the permeability status of the pleural space was evaluated in 42 carcinomatous pleuritic cases. The sequential changes of concentrations of MMC and ADM in blood were measured following intrapleural instillation in 27 cases, and pleural fl uid levels of MMC, ADM, CPA and FT were examined in 15 cases after systemic infusion. In patients without thickened pleuras, the permeability of the drugs was rapid, however in thickened pleural cases the permeability of the pleura was in inverse proportion to its thickness. Therefore in cases with thickened pleura the local instillation of the anticancer agents was more effective.
The level of glucose in pleural effusions of 60 cases was examined. It was quite low in cases of thickened pleura, however a high level of glucose as in serum was seen in normal cases. Therefore, the glucose level of the pleural fluid can be used as a marker of the pleural thickening.
