摘要
目的优化基本气管镜操作技术对于肺癌诊断非常重要,本研究评估了在支气管肺癌诊断中,经支气管镜活检和刷检的顺序,哪一个可以获得更高的诊断率。方法我们对支气管内可见的98例肺癌患者随机分为两组:一组先活检再刷检,一组先刷检再活检。并对两组不同顺序操作的诊断率进行了比较,并对两组肿瘤的病理和镜下表现也进行了比较。只有通过支气管镜下基本操作后得到组织学、细胞学确诊的患者才能入组。并排除了外压性改变没有管腔内表现、肺转移性肿瘤、不常见的肺癌类型。结果发现先刷检在活检组的诊断率比先活检再刷检的患者诊断率明显提高(78.4%,40/51 VS 38.3%,18/47)(P<0.05)。原因可能与先活检后黏膜出血影响刷检结果有关。结论支气管刷检作为支气管镜检查的基本手段在临床运用中十分重要,本研究中,先刷检再活检优于先活检再刷检的基本操作,得到临床推广。
Objective To discuss brushing and biopsy order in the basic techniques of bronchoscopy.Methods A total of 98 patients with visible endobronchial tumors were prospectively and randomly enrolled in two groups: the pre-biopsy brushing group receiving twice brushing before biopsy,and the post-biopsy brushing group,only receiving twice brushing after biopsy. Diagnostic yield of brushing was compared before and after biopsy,and as well as for different tumor pathologies and bronchoscopic morphologies. Only patients with a definitive cytological or histological diagnosis of lung cancer based on bronchoscopy techniques were included. Patients were excluded if they had submucosal lesions,extrinsic compressions,pulmonary metastasis of extrapulmonary malignancies or uncommon non-small cell lung carcinoma( NSCLC). Results The diagnostic yield for pre-biopsy brushing( 78. 4%,40/51)was significantly higher than post-biopsy brushing within the same pre – biopsy brushing group( 38. 3%,18/47)( P < 0. 05). The reason might be related to the effect of mucosal bleeding caused by bronchoscopy biopsy. Conclusion Supplementing bronchoscopic forceps biopsy with brushing improves diagnostic yield in lung cancer. In our cases,pre-biopsy brushing appears to be superior to post-biopsy brushing and it worth clinical promotion.
出处
《临床肺科杂志》
2017年第12期2283-2286,共4页
Journal of Clinical Pulmonary Medicine
关键词
气管镜
活检
刷检
肺癌
基本气管镜技术
bronchoscopy
biopsy
brushing
lung cancer
basic bronchoscopy techniques
