纤维支气管镜术后痰细胞学检查在肺癌诊断中的意义  

Value of Sputum Cytology for Postoperative Patients Underwent Fiberoptic Bronchoscopy in Diagnosis of Lung Cancer

作　　者：马家兰[1] 黄晓霞[1] 肖卫[1] 许菊秀[1] 陈振平[1] 李芬[1] 

机构地区：[1]长江大学附属第一医院呼吸内科,湖北省荆州市434000

出　　处：《中华全科医学》2012年第6期843-844,共2页Chinese Journal of General Practice

摘　　要：目的观察纤维支气管镜术后痰细胞学检查对肺癌的诊断价值。方法对120例行纤维支气管镜患者术前送2～3次痰细胞学,术后第1～4天送2～3次痰细胞学检查。结果 120例有79例确诊为肺癌,其中75例通过术前痰检,纤支镜刷检、活检、冲洗液及术后痰检联合检查确诊肺癌,术前痰细胞学检出癌23例,阳性率29.1%,其细胞学分类与组织学活检分类符合率鳞癌63.6%、腺癌60.0%、小细胞癌66.7%。术后痰细胞学检出癌42例,阳性率53.20%,术后痰检与组织活检符合率鳞癌87.5%、腺癌88.2%、小细胞癌83.3%%。结论纤维支气管镜检结合术后痰细胞学检查可提高肺癌的检出率,术后痰细胞学阳性率及准确性均较术前痰高。术后痰细胞学检查无创、安全可重复,值得临床应用。Objective To explore the value of sputum cytology in the diagnosis of lung cancer for postoperative patients who underwent fiberoptic bronchoscopy.Methods 120 patients accepted 2-3 sputum cytological examinations before fiberoptic bronchoscopy and 1-4 days after fiberoptic bronchoscopy.Results Among the 120 cases 79 cases were diagnosed as lung cancer,75 cases were confirmed by different examinations including sputum cytology before fiberoptic bronchoscopy,brush cytology,biopsy,liquid washing and postoperative sputum cytology.23 cases of cancer were found in preoperative sputum cytology,the positive rate was 29.1%,the cytotyping accuracy was 63.6% in squamous carcinoma,60.0% in adenocarcinoma and 66.7% in small cell carcinoma.42 cases of cancer were found in postoperative sputum cytology,the positive rate was 53.2%,the cytotyping accuracy was 87.5% in squamous carcinoma,88.2% in adenocarcinoma and 83.3% in small cell carcinoma.Conclusion Sputum cytology for postoperative patients who underwent fiberoptic bronchoscopy can increase the detectable rate of lung cancer.The positive rate and accuracy of postoperative sputum cytology are better than that of preoperative sputum cytology.The postoperative sputum cytology is noninvasive,safe and repeatable,it is worthy of clinical application.

关 键 词：纤维支气管镜 痰细胞学 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]