痰和纤维支气管镜刷片细胞学检查在肺癌诊断中的意义  

Value of Sputum and Brush Cytology in the Diagnosis of Lung Carcinomas

作　　者：郭会芹[1] 张智慧[1] 曹箭[1] 赵琳琳[1] 李中林[1] 王乃鹏[1] 

机构地区：[1]中国协和医科大学中国医学科学院肿瘤医院肿瘤研究所病理科,100021

出　　处：《实用癌症杂志》2009年第1期57-59,共3页The Practical Journal of Cancer

摘　　要：目的探讨痰和纤支镜刷片细胞学检查在肺癌诊断中的意义。方法收集532例同时进行痰和纤支镜检查的肺癌病例,分析痰和纤支镜刷片细胞学检查的敏感性和分型的准确性,与纤支镜咬检组织学对比,评价细胞学在肺癌诊断中的意义。结果痰细胞学的敏感性为33.8%,纤支镜刷片细胞学的敏感性为58.7%,纤支镜咬检组织学的敏感性为39.1%。痰细胞学分型诊断与组织学的符合率鳞癌为95.7%,腺癌为87.2%,小细胞癌为100.0%,痰细胞学区分小细胞癌和非小细胞癌的准确性为100.0%。纤支镜刷片细胞学分型诊断与组织学的符合率鳞癌为93.3%,腺癌为85.4%,小细胞癌为95.5%,纤支镜刷片细胞学区分小细胞和非小细胞癌的准确性为98.0%。结论纤支镜刷片细胞学具有较高的敏感性,在肺癌的诊断中有重要的应用价值。痰细胞学敏感性较低,但可作为纤支镜检查阴性和不能耐受纤支镜检查的肺癌患者的补充检查手段。两者的细胞学分型具有较高的可信度。Objective To evaluate the role of sputum and brush cytology in the diagnosis of lung cancer. Methods 532 patients with lung cancer were retrospectively analyzed. Both sputum and bronchoscopic cytology were performed to all patients. The sensitivity and cytotyping accuracy of sputum and brush methods were analyzed and compared with bronchial biopsy. Results The sensitivity of sputum cytology, brush cytology and biopsy was 33.8% ,58.7% and 39.1%. The cytotyping accuracy was 95.7% in squamous carcinoma,87.2% in adenocarcinoma and 100.0% in small cell carcinoma for sputum cytology. The cytotyping accuracy for brush method was 93.3% in squmaous carcinoma,85.4% in adenocarcinoma and 95.5% in small cell carcinoma. The overall accuracy of diagnosing small cell lung cancer and non - small cell lung cancer of sputum and brush methods was 100.0% and 98.0% respectively. Conclusion Brush cytology shows a high sensitivity in the diagnosis of lung cancer. Sputum cytology can be performed as an adjunct to the bronchoscopic techniques. Both methods provide a reliable cytotyping diagnosis.

关 键 词：痰 纤支镜刷片 肺癌 

分 类 号：R730.4[医药卫生—肿瘤] R734.2[医药卫生—临床医学]