经纤维支气管镜不同取材方法对肺癌的诊断价值  

Diagnostic value of different sampling under fibrobronchoscope for lung cancer

作　　者：夏国际 徐劲松 熊焕文 兰静 叶新龙 

机构地区：[1]解放军九四医院呼吸内科,江西南昌330002

出　　处：《临床肺科杂志》2015年第7期1171-1174,共4页Journal of Clinical Pulmonary Medicine

基　　金：南京军区医学科技创新课题(No 09z017);江西省卫生厅科技计划项目(No 20093205)

摘　　要：目的评价纤维支气管镜(纤支镜)下不同取材方法对肺癌诊断的价值,探讨纤支镜下联合采用多种取材方法对肺癌诊断的临床意义。方法分析130例肺癌患者的纤支镜检查结果,比较钳检、刷检、经纤支镜肺活检(TBLB)、单纯经纤支镜针吸活检(TBNA)、支气管肺泡灌洗(BAL)及联合取材方法诊断肺癌的阳性率。结果 130例肺癌经纤支镜确诊122例,镜下分为六型:中央增生型、中央浸润型、中央外压型、中央正常型、周围增生浸润型、周围外压正常型;钳检、刷检、TBLB、TBNA、BAL的阳性率分别为83.33%、56.92%、50.00%、67.35%、42.31%,钳检阳性率明显高于另4种单一方法取材(P<0.05);不同镜下类型分别采用刷检联合其他4种方法检查的总阳性率为93.85%(122/130),平均阳性率为89.99%;不同取材方法对不同镜下类型肺癌的检出不同。结论根据镜下特点的不同采取不同经纤支镜取材方法、重视钳检、积极开展TBLB、TBNA、联合多种取材方法可提高肺癌的病理学诊断率。Objective To evaluate the diagnostic value of different sampling under fibrobronchoscope for lung cancer. Methods The fibreoptic bronchoscopy results of 130patients with lung cancer were retrospectively ana-lyzed. The diagnostic positive rate was compared among clamp biopsy, brush biopsy, transbronchial lung biopsy （ TBLB） , transbronchial needle aspiration biopsy （ TBNA） , bronchoalveolar lavage （ BAL） and the combined bron-chofibroscopic biopsy. Results The manifestation in 130 final diagnosed lung cancer patients with fibrobronchoscope could be classified as proliferation, infiltration, suppression and normal forms. The positive rate of clamp biopsy, brush biopsy, TBLB, TBNA and BAL was 83. 33%, 56. 92%, 50. 00%, 67. 35% and 42. 31% respectively, which of clamp biopsy were the highest （P〈0. 05）. The total positive rate in different lesion with brush biopsy combining other four methods was 93. 85% （122/130）, and the average positive rate was 89. 99%. The positive rate was dif-ferent while using different drawing materials method through fibrobronchoscope for different types of lung cancer. Conclusion According to the different type of lung cancer to get specimen at different way, the combined sampling can improve the positive diagnostic rate of lung cancer via fibrobronchoscope.

关 键 词：纤维支气管镜 联合取材 肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤]