摘要
目的探讨支气管镜活检联合液基细胞学检查对右中叶肺癌的诊断价值。方法 98例肺部CT提示右中叶肿瘤、且行支气管镜活检并在镜下能直视右中叶病变患者作为研究对象,取活检组织进行病理学检查,支气管镜活检后吸引行膜式超薄液基细胞学检测技术(TCT)及传统细胞学涂片(CS)检查,比较支气管镜活检联合TCT检查、支气管镜活检联合CS检查、支气管镜活检组织病理检查的阳性率;同时比较TCT检查与CS检查的敏感度、特异度、准确率、阳性预测值、阴性预测值。结果 98例患者,其中68例最终确诊为右中叶肺癌,通过支气管镜活检组织病理检查诊断出肺癌51例,支气管镜活检联合TCT检查诊断出肺癌66例,支气管镜活检联合CS检查诊断出肺癌60例;支气管镜活检联合TCT检查阳性率高于支气管镜活检联合CS检查阳性率和支气管镜活检组织病理检查阳性率,支气管镜活检联合CS检查阳性率高于支气管镜活检组织病理检查阳性率,差异有统计学意义(P<0.05)。TCT检查右中叶肺癌患者阳性43例,阴性25例;良性病变患者阳性0例,阴性30例;CS检查右中叶肺癌患者阳性29例,阴性39例;良性病变患者阳性2例,阴性28例。TCT检查的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为63.24%、100.00%、74.49%、100.00%、54.55%, CS检查敏感度、特异度、准确率、阳性预测值及阴性预测值分别为42.65%、93.33%、58.16%、93.55%、41.79%, TCT检查的敏感度、准确率高于CS检查,差异均有统计学意义(P<0.05)。结论活检组织病理学联合TCT检查能提高对右中叶肺癌诊断阳性率,且TCT检查比CS检查诊断效率高,在临床中有很好的应用价值。
Objective To investigate the diagnostic value of bronchoscopic biopsy combined with ThinPrep cytologic test on right middle lobe lung cancer. Methods A total of 98 patients with right middle lobe lesions could be viewed directly under the microscope, who pulmonary CT showed right middle lobe tumors and performed bronchoscopic biopsy were selected as research objects. Biopsy tissues were taken for pathological examination. After bronchoscopic biopsy, ThinpPep cytologic test (TCT) and conventional smear (CS) examinations were performed. The positive rates of bronchoscopic biopsy combined with TCT examination, bronchoscopic biopsy combined with CS examination and bronchoscopic biopsy combined with histopathological examination were compared, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TCT examination and CS examination were compared at the same time. Results In 98 patients, among them, 68 cases were finally diagnosed as right middle lobe lung cancer, 51 cases of lung cancer were diagnosed by bronchoscopic biopsy combined with histopathological examination, 66 cases by bronchoscopic biopsy combined with TCT examination, and 60 cases by bronchoscopic biopsy combined with CS examination. The positive rate of bronchoscopic biopsy combined with TCT examination was higher than that of bronchoscopic biopsy combined with CS examination and bronchoscopic biopsy combined with histopathological examination, the positive rate of bronchoscopic biopsy combined with CS examination was higher than that of bronchoscopic biopsy combined with histopathological examination, the differences were statistically significant (P<0.05). TCT examination was positive in 43 cases and negative in 25 cases of right middle lobe lung cancer, benign lesions were positive in 0 case and negative in 30 cases. CS examination was positive in 29 cases and negative in 39 cases of right middle lobe lung cancer, benign lesions were positive in 2 cases and negative in 28 cases. The sensitivity, specificity
作者
冷永杰
李再清
LENG Yong-jie;LI Zai-qing(Department of Respiratory Medicine, Shaoyang Central Hospital Affiliated to University of South China, Shaoyang 422000, China)
出处
《中国实用医药》
2018年第36期24-26,共3页
China Practical Medicine
