中央型非小细胞肺癌侵犯支气管树近端范围的术前判断  

Preoperative diagnosis of proximal bronchial invasion of central non-small cell lung cancer

作　　者：宋福杰 王洲[2] 刘相燕[2] 

机构地区：[1]煤炭总医院胸外科,北京100008 [2]山东省立医院胸外科,济南250021

出　　处：《中国肿瘤临床与康复》2014年第11期1334-1336,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨应用纤维支气管镜(纤支镜)和CT检查判断中央型非小细胞肺癌(NSCLC)侵犯支气管近端范围(T分期)的价值。方法分析125例行手术治疗的中央型NSCLC患者术前纤支镜及CT检查结果,以术后病理结果为金标准,比较2种方法判断NSCLC患者肿瘤侵犯支气管近端范围的价值。结果纤支镜判断肿瘤侵犯支气管近端范围的敏感度、特异度、阳性预测值、阴性预测值和符合率分别为88.0%、93.0%、86.0%、94.0%和92.0%,CT检查分别为64.0%、82.0%、63.0%、82.0%和76.0%,差异均有统计学意义(P<0.01)。纤支镜和CT检查对T1期的判断结果差异无统计学意义,对T2期的判断结果差异有统计学意义(P<0.05),对T3期的判断结果除特异度(88.7%、83.1%)、阳性预测值(86.4%、72.7%)无差异(P>0.05)外,其他3项指标均有明显差异(P<0.01)。结论术前纤支镜检查结合CT检查能更为准确地判断中央型NSCLC肿瘤侵犯支气管近端的范围,对于T2、T3期病变,纤支镜检查更为准确。Objective To analyse the different results of fiberoptic-bronchoscope and CT in diagonosis of invasion of proximal bronchial tree by central non-small cell lung cancer（NSCLC）.Methods The results of fiberoptic-bronchoscope examination and CT scan in 125 cases with central non-small cell lung cancer were analysed,compared with pathological results in all patients.The comparison of sensitivity,specificity,positive and negative predictive value,accuracy to T stage between fiberoptic-bronchoscope and CT was made.Results The sensitivity,specificity,positive predictive value,negative predictive value,accuracy of fiberoptic-bronchoscope to T staging were 87.8 % 、93.3 % 、86.4% 、94.2% 、91.5%,respectively,which of CT were 64.2% 、81.7% 、63.2 % 、82.4 % 、76%,respectively.Fiberoptic-bronchoscope was superior to CT in sensitivity,specificity,positive predictive value,negative predictive value,accuracy by chisquare test（P 〈 0.01）.There were significant differences in T2 and T3 stage.Conclusion Fiberopticbronchoscope was superior to CT in dignosis of the extent of proximal bronchial invasion of central non-small cell lung cancer in T2 and T3 stage.

关 键 词：纤维支气管镜 X线计算机体层成像 癌 非小细胞肺 支气管 

分 类 号：R734.2[医药卫生—肿瘤]