传统支气管针吸活检术在基层医院诊断原发性肺癌中的运用价值  

Traditional transbronchial needle aspiration biopsy in the diagnosis of primary lung cancer in the use of value in the primary hospital

作　　者：张齐[1] 陶峰[1] Zhang Qi Tao Feng(Department of Respiratory, the First Hospital of Jiaxing , Jiaxing , Zhejiang 314201, China)

机构地区：[1]嘉兴市第一医院呼吸内科,浙江省嘉兴314201

出　　处：《中国基层医药》2016年第24期3709-3712,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省嘉兴市科技计划项目（2013AY21042-1）

摘　　要：目的：探讨传统支气管针吸活检术（C-TBNA）在基层医院诊断原发性肺癌中的运用价值。方法回顾性分析嘉兴市第一医院呼吸科2013年1月至2014年12月经 C-TBNA 病理诊断的原发性肺癌患者118例临床资料，其中包括淋巴结的穿刺和肺内肿块的穿刺，同时所有患者均行胸部 CT 检查。结果通过对118例 C-TBNA 阳性患者的病理分析，其中腺癌45例（38．1％）、鳞癌28例（23．7％）、小细胞癌17例（14．4％）。联合 TNBA 淋巴结与胸部 CT 比较，C-TBNA 淋巴结穿刺在肺癌诊断及分期中明显优于胸部 CT，并减少胸部 CT 淋巴结的假阴性率。C-TBNA 淋巴结的阳性率与穿刺区域无关，118例患者取得淋巴结穿刺标本289份，其中阳性标本194份，分三个区域（上纵隔区，下纵隔区，10～14区），对三个区域进行组间率比较，差异无统计学意义（P ＝0．407），所有患者检查耐受性良好，均无相关并发症。结论 C-TBNA 作为肺门、纵隔淋巴结及肺内肿块病理评估手段，明显提高肺癌的诊断阳性率，其穿刺阳性率与穿刺区域无关。气管镜在肺癌诊断的应用中安全、有效、可行。Objective To investigate traditional transbronchial needle aspiration biopsy （C-TBNA）using the diagnostic value of lung cancer in primary hospital.Methods The clinical data of patients with 118 cases of primary lung cancer was analyzed retrospectively and the respiratory department of the First Hospital of Jiaxing from January 2013 to December 2014 period was analyzed by C-TBNA pathologic diagnosis,including the lymph nodes and lung tumor puncture biopsy.Meanwhile,all patients did chest CT.Results By means of the positive C-TBNA patho-logic analysis among the 118 cases of patients,it gets the result of 45 cases of adenocarcinoma （38.1%）,squamous cell carcinoma and 28 cases （23.7%）,small cell carcinoma in 17 patients （14.4%）.Combining the TNBA lymph nodes and the chest CT comparison,C -TBNA lymph node biopsy in the diagnosis and staging of lung cancer was found significantly better than the chest CT.It can reduce the false negative rate of the chest CT lymph nodes.The positive rate of C -TBNA lymph nodes 1is regardless of the puncture area.118 patients made 289 parts by lymph node biopsy specimens,including 194 positive samples which are divided into three regions （the mediastinum and lower mediastinal region,10 -14 region）.Comparing the three groups’region rates,no statistical significant difference was found （P =0.407）.All patients was well tolerated,no complications.Conclusion As hilus pulmonis and mediastinal lymph nodes and lung tumor pathology assessment tools,C-TBNA can significantly improve the diagnostic yield of lung cancer.In addition,the positive rate is regardless of the puncture puncture area.The application of bronchoscopy of lung cancer diagnosed is safe,effective and feasible.

关 键 词：肺肿瘤 淋巴结 活组织检查 针吸 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]