经支气管镜针吸结合刷片和钳夹活检在支气管壁内和管壁外恶性病变的诊断价值  

Diagnostic value of bronchoscopic needle biopsy combined with brush and clamp biopsy in malignant tumor within or outside the bronchial wall

作　　者：朱金秀[1] 钟爱虹[1] 林清华[2] 魏淑芳[3] 

机构地区：[1]福建医科大学临床教学医院福州肺科医院肿瘤科,福建福州350008 [2]福建医科大学临床教学医院福州肺科医院病理科,福建福州350008 [3]福建医科大学临床教学医院福州肺科医院内镜中心,福建福州350008

出　　处：《临床肺科杂志》2016年第12期2142-2145,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨经支气管镜针吸与刷片和钳夹活检技术联合，对支气管壁内和管壁外恶性病变进行病理取材的诊断价值。方法在胸部CT提示肺门、纵隔淋巴结肿大（大于1cm）合并肺部病变、纵隔肿物的32例患者，予常规纤维支气管镜检查经支气管镜针吸活检（TBNA）术并行刷检和钳检，对获取的标本进行细胞学及组织病理学检查。结果32例最终均确诊为胸部恶性肿瘤，经支气管镜针吸活检（TBNA）、刷检、钳检的阳性检出率分别为59．4％、65．5％和40．0％，三者联合取材的阳性率84．4％（趋势检验x2=6．0，P值〈0．05）。所有患者均无明显的并发症。结论联合取材的方法安全、方便，还具有创伤小，阳性率高等优点，对胸部恶性肿瘤的诊断和分期判定有很大帮助。Objective To explore the diagnostic value of bronchoscopic needle biopsy combined with brush and clamp in malignant tumor within or outside the bronchial wall. Methods In thoracic CT tips pulmonary, 32 pa- tients with pulmonary diseases complicated with mediastinal lymphadenopathy （ 〉 1cm） mediastinal tumors were giv- en general fiberoptic bronchoscopy with transbronchial needle aspiration （TBNA） parallel with brushing and clamp, and specimens were given cytological and histopathological examination. Results 32 cases were ultimately diagnosed with thoracic malignancies. The positive rate of TBNA, bronchial brush and clamp biopsies was 59. 4%, 65.5% and 40. 0% respectively. The use of TBNA increased the diagnostic yield of bronchoscopy from 59.4% to 84.4% （ X2 = 6. 0, P 〈 0. 05）. No complications occurred. Conclusion The combined detection has the advantages of high safety, easy operation, small trauma and high positive rate, which is very helpful for the diagnosis and staging of malignant tumor.

关 键 词：TBNA 纤维支气管镜 肺癌 淋巴结 

分 类 号：R734[医药卫生—肿瘤]