纤维支气管镜筛查胸部X线“三阻征”早期中央型肺癌的结果分析  

Analysis of the results of early central-type pulmonary carcinoma in three obstructive signs on chest X ray screened by fiberbronchoscope

作　　者：罗维贵[1] 李文强[1] 林剑勇[1] 许建国[1] 梁琼[1] 李清锋[1] 牛黎明[1] 韦中盛[1] 许杰[1] 

机构地区：[1]广西右江民族医学院附属医院呼吸内科,广西壮族自治区百色市533000

出　　处：《中国综合临床》2008年第7期637-639,共3页Clinical Medicine of China

基　　金：基金项目：广西科学研究与技术开发计划项目（200510205）

摘　　要：目的探讨纤维支气管镜检查对胸部X线“三阻征”早期中央型肺癌的诊断率、病理类型分布及痰找癌细胞的阳性率。方法对326例胸部X线“三阻征”的肺癌高危患者采用螺旋CT扫描、纤维支气管镜活检以及痰细胞检查进行中央型肺癌筛查。结果确诊为中央型肺癌32例，患病率9、8％；其中阻塞性肺炎21例（65．6％），阻塞性肺不张7例（21．9％），阻塞性肺气肿4例（12．5％）；病理类型为鳞癌16例（50.0％），小细胞癌9例（28．1％），大细胞癌3例（9、4％），腺癌2例（6．3％），腺鳞癌1例（3．1％），支气管腺体癌1例（3．1％）；32例痰找到癌细胞5例，其中阻塞性肺炎21例痰找到癌细胞3例（14．3％），阻塞性肺不张7例痰找到癌细胞1例（14．3％），阻塞性肺气肿4例痰找到癌细胞1例（25.0％）。结论胸部X线“三阻征”可以作为早期中央型肺癌的筛查指标。病理类型以鳞癌、小细胞癌多见，筛查可提高早期肺癌的检出率。Objective To explore the diagnosis rate ,pathology types and positive rate of cancer cell in sputum of early central pulmonary carcinoma in three obstructive signs on chest X ray screened by fiberbrornchoscope. Methods 326 cases of three obstructive signs with high risk of lung cancer were screened for central pulmonary carcinoma by spiral CT, biopsy by fiberbronchoscope and cytological examination of sputum, Results 32 patients were diagnosed with central pulmonary carcinoma,with morbidity of 9.8%. In these patients ,21 were confirmed with obstructive pneumonia（65.6% ） ,7 with obstructive atelectasis（21.9% ） ,4 with obstructive emphysema（ 12.5% ） ; In terms of pathology type, 16 cases were defined as squamous cell carcinoma（50.0% ） ,9 as small cell carcinoma （28.1%） ,3 were as large cell carcinoma（9.4% ） ,2 were as adenocarcinoma （6.3%）, 1 as adrnosquamous carci- noma（3.1% ）, 1 as bronchial gland carcinoma （3.1%） ;cancer cell could be found in sputum of 5 patients of 32 cases,among them,it was found in 3 of 21 patients with obstructive pneumonia（ 14.3% ）, 1 in 7 patients with obstructive atelectasis（ 14.3% ）, 1 in 4 patients with obstructive emphysema（ 25.0% ）. Conclusion The prevelance of early central pulmonary carcinoma in three obstructive signs on chest X-ray is 9. 815% , in which squamous carcinoma and small-cell carcinoma are common in pathology type. Screening can increase the detection rate of early pulmonary carcinoma.

关 键 词：肺癌 纤维支气管镜 阻塞性肺炎 阻塞性肺不张 阻塞性肺气肿 病理检查 

分 类 号：R734.2[医药卫生—肿瘤]