摘要
目的探讨经纤维支气管镜下联合取材对肺癌的诊断价值。方法深州市医院胸外科2006年8月—2010年6月应用纤维支气管镜对疑诊肺癌病例进行检查,确诊肺癌414例。比较钳检、刷检、冲洗及针吸活检(TB-NA)4种不同取材方法单一及联合取材对肺癌的检出率。结果将确诊肺癌患者标本的镜下表现分为4型:增生型(53.4%)、浸润型(25.8%)、外压型(11.4%)、正常型(9.4%)。钳检的检出率显著高于其他3种单一取材方法(P<0.01);钳检+刷检+冲洗+TBNA联合取材总检出率显著高于单一取材方法及其他组合方式(P<0.01)。增生型肺癌中钳检法的检出率显著高于其他3种单一取材方法(P<0.01);浸润型、外压型肺癌中其他3种单一取材方法的检出率显著高于冲洗法(P<0.05);正常型肺癌中刷检法、冲洗法的检出率显著高于钳检法(P<0.05)。结论纤维支气管镜检查对肺癌的诊断有重要价值。不同取材方法对镜下不同类型肺癌的诊断价值不同,联合多种取材方法可明显提高肺癌的诊断率。
Objective To investigate the diagnostic value of associated material methods under fibrobroncho- scope in treatment of patients with lung cancer. Methods Cases of suspected lung cancer during August 2006 and June 2010 in our department were examined by fiberoptic bronehoscopy, and 414 cases were diagnosed as having lung cancer. The detection rates of lung cancer by forceps biopsy, brush smears, bronchial lavage cytology, transbronchial needle aspi- ration （TBNA） single and associated material methods were compared. Results The manifestations of patients with lung cancer under fibrobronchoscope were classified four types： proliferative type（53.4% ）, infiltrating type（25.8% ）, sup- pression type （ 11.4% ） and normal type （9.4%）. Detection rate of forceps biopsy was significantly higher than those of the other three single material methods （P 〈 0.01 ） ; the total detection rate of forceps biopsy ＋ brush smear ＋ bronchial lavage cytology ＋ TBNA associated material methods was significantly higher than those by single material method or other combinations methods （P 〈 0.01 ） ; detection rate of external pressure lung washing method was significantly higher than those of the other three single material methods in infiltrating type and external pressure lung cancer （ P 〈 0.05 ）. Detec- tion rates of brush smears and bronchial lavage cytology were significantly higher than that by forceps biopsy（ P 〈 0. 05 ）. Conclusion The fiberoptic bronchoscopy has important value in diagnosis of lung cancer. Different material methods un- der endoscopic have diagnostic value in diagnosis of different lung cancers, and the method of combined with a variety of materials method can significantly increase the diagnosis rate of lung cancer.
出处
《解放军医药杂志》
CAS
2013年第5期60-62,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
