经纤支镜肺活检肺外周小结节肺癌28例阴性分析  

The negative result analysis of transbronchial lung biopsy of 28 cases of peripheral pulmonary nodules

作　　者：魏霞 李洁 崔亚娟 

机构地区：[1]西安市第九医院呼吸科,陕西西安710054

出　　处：《临床肺科杂志》2011年第8期1235-1236,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的重视提高周围型小结节肺癌的早期诊断。方法回顾分析28例纤支镜检阴性的周围性小结节肺癌临床特点,分析确诊的方法。结果 28例肺活检阴性的肺外周小结节肺癌,经手术确诊12例,CT引导下经皮肺穿刺确诊10例,胸水及心包积液脱落细胞确诊4例,淋巴结活检确诊2例。开胸手术及经皮肺活检确诊病例占78%。组织学类型:腺癌16例,鳞癌10例,小细胞未分化癌2例,腺癌比例占57%。血CEA升高者6例,均高于正常5倍以上。结论经纤支镜肺活检阴性的肺外周小结节病变,应重视通过手术或经皮肺活检获得病理诊断,提高小结节肺癌早期诊断率。血、胸水、肺泡灌洗液CEA的检测有助肺癌的诊断。Objective To improving small peripheral lung nodules early diagnosis.Methods Retrospective analysis of 28 patients was conducted with negative bronchoscopy examination of small nodules around the clinical features of lung cancer.Results For the 28 patients with biopsy-negative pulmonary nodules in peripheral lung cancer,12 cases were confirmed by surgery,10 cases by CT-guided percutaneous lung biopsy,4 cases by pleural and pericardial effusion cytology and 2 cases by,lymph node biopsy.Thoracic surgery and percutaneous lung biopsy accounted for 78%.Histology types： adenocarcinoma in 16 cases,squamous cell carcinoma in 10,small cell undifferentiated carcinoma,in 2 and 57% in adenocarcinoma.Elevated serum CEA in 6 patients,more than 5 times higher than normal.Conclusion The negative transbronchoscopy lung biopsy of small peripheral lung nodules,attention should be paid by surgery or percutaneous lung biopsy to obtain pathological diagnosis,and to improve the early diagnosis of lung nodules.The blood,pleural fluid and BALF CEA examination is helpful in the diagnosis of lung cancer.

关 键 词：肺肿瘤 TBLB 结节 癌胚抗原 

分 类 号：R734.2[医药卫生—肿瘤]