气管镜活检并刷片结合经支气管针吸活检在肺癌诊断中的作用  

Diagnostic value of bronchoscopic bronchial brushing and clamp biopsies combination with transbronchial needle aspiration in patients with lung cancer

作　　者：蔡后荣[1] 周贤梅[1] 聂进军[2] 母国华[1] 柏涛[2] 孟凡青[2] 

机构地区：[1]南京大学医学院附属鼓楼医院呼吸内科,江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《中国内镜杂志》2006年第12期1261-1262,1265,共3页China Journal of Endoscopy

摘　　要：目的探讨气管镜活检并刷片结合经支气管针吸活检联合病理取材对肺癌的诊断价值。方法在常规气管镜检查过程中,对CT检查提示肺部病变同时有纵隔及肺门淋巴结肿大的20例患者,在常规气管镜活检并刷片的基础上,并对纵隔淋巴结肿大予以经支气管针吸活检术(transbronchialneedleaspiration,TBNA),对所获标本进行细胞学及组织学切片检查。结果20例患者中,17例获得明确的组织学诊断,钳检、刷检、TBNA术的阳性率分别为60%、50%和50%,三者联合病理取材的阳性率为85%,其中有5例活检并刷片未能明确诊断,TBNA术明确诊断,使气管镜检查诊断的阳性率由60%上升至85%。所有患者均无明显的并发症。结论TBNA术操作方便、安全,联合病理取材可提高肺癌的病理学诊断率。[Objectives] Investigate the diagnostic value of bronchial bmshing and clamp biopsies combination with transbronchial needle aspiration（TBNA） for mediastinal lymphnodes in patients with lung cancer. [Methods] The standard bronchoscopic procedures, bronchial bmshing, clamp biopsies and TBNA were performed in twenty patients with lung lesions and mediastinal lymphnodes in CT scan of chest. The samples of TBNA for mediastinal lymphnodes, bronchial brushing and clamp biopsies were examine pathologically and cytologically. [Result] The positive rates of TBNA, bronchial bmsh and clamp biopsies were 50%, 50% and 60 % respectively. In 5 cases, TBNA was the only diagnostic technique with a positive result. The use of TBNA increased the diagnostic yield of bronchoscopy from 60 to 85%. NO complications were seen other than minimal bleeding. [Conclusions] The technique of TBNA for mediastinal lymphnodes through bronchoscope in combination with bronchial brush and clamp biopsies was simple, safe and of few complications, and it increased bronchoscopic diagnostic efficacy in patients with lung cancer.

关 键 词：经支气管针吸活检术 支气管镜检查 肺癌 淋巴结 

分 类 号：R734.2[医药卫生—肿瘤] R768.1[医药卫生—临床医学]