[Detection and dispensary care of groups of persons at increased risk of bronchogenic cancer disease in Czechoslovakia]. / Vyiavlenie i dispanserizatsiia grupp lits povyshennogo riska zabolevaniia bronkhogennym rakom v Chekhoslovakii.

Epidemiological and clinical studies organized by the Tuberculosis and Respiratory Diseases Research Institute, Prague, revealed that the main high-risk factors associated with the incidence of lung cancer in Czechoslovakia are as follows: are and sex, heavy cigarette smoking, persistent cough, expectoration and other symptoms of chronic respiratory disease, and lung lesions of tuberculosis or probably tuberculosis origin. The methods used in Czechoslovakia for lung cancer detection include photofluorography, which has been combined in some investigations with a standard questionnaire eliciting smoking habits and symptoms of respiratory disease. Cytological sputum investigation in suspicion to lung cancer was found to be a useful contribution to the diagnosis. The systematic dispensary control of persons with bronchogenic carcinoma or at high risk for this disease is provided by polyclinic Departments for Tuberculosis and Respiratory Diseases of the District Institutes of National Health in collaboration with general physicians, oncological and other specialized departments. Further studies on methods for detection and dispensary control of lung cancer high-risk groups represent an important research task.

Open lung biopsy.

During 16 years (1958-1974) 327 open lung biopsies were carried out in the Tuberculosis and Respiratory Diseases Research Institute, the 2md and 3rd Surgical Clinic of Charles University in Prague. A modification of the original Klassen's surgical technique with axillary or submammary approach was used. The patients (160 males, 167 women) were referred for biopsy because of various forms of diffuse pulmonary lesions without established diagnosis. The age of the patients varied from 6-72 years, 27 of them, aged over 60, were operated on nothwithstanding their compromised cardiopulmonary function. In 252 (79%) the definite diagnosis with characteristic histology was obtained, and in 70 (21%) only pulmonary fibrosis without exact specification was evaluated. The definite histologic findings were as follows: 102 (31%) diffuse interstitial pulmonary fibrosis (Hamman-Rich), 32 (10%) pulmonary lesions in systemic cardiopulmonary or bronchopulmonary diseases (collagenosis, eosinophilic and other granulomas, Wegener, hemosiderosis, etc.), 42 (13%) pulmonary sarcoidosis, 12 (4%) pulmonary tuberculosis, 45 (14%) pneumoconiosis, mostly silicosis, 24 (7%) neoplastic lesions. Post-operative morbidity of minor importance was 13,5%, mortality 0,3%: One 56 years old woman died 5 days following operation of cardiopulmonary insufficiency. This was an incorrect indication for biopsy based on inadequate evaluation of the patient's initial functional status. The open lung biopsy obtained by minimal thoracotomy is a valuable and well tolerated diagnostic method in cases where diagnosis cannot be obtained with certainty on the base of results of usual investigation procedures.