支气管镜联合刷检液基细胞学对周围型肺癌早期诊断的临床研究  

Early diagnosis of peripheral lung cancer by bronchoscopy combined with brush liquid-based cytology

作　　者：刘岩[1] 孙如坤[1] 刘勇[1] 王文光[2] LIU Yan;SUN Ru-kun;LIU Yong;WANG Wen-guang(Department of Respiratory and Critical Care Medicine,Zhoukou Central Hospital,Zhoukou,Henan 466000,China;Department of Oncology,Henan Chest Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]周口市中心医院呼吸与危重症医学科,河南周口466000 [2]河南省胸科医院肿瘤科,河南郑州450000

出　　处：《临床肺科杂志》2021年第9期1395-1399,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究支气管镜联合刷检液基细胞学对周围型肺癌早期诊断价值的探讨。方法选取2018年1月至2019年12月本院接诊的300例周围型肺部结节病变患者,均行支气管镜、刷检液基细胞学检查、B超经皮肺穿刺活检,以病理诊断结果为标准,将诊断结果与病理诊断结果对照;绘制受试者工作特征曲线(ROC)分析诊断价值;统计患者经支气管镜联合刷检液基细胞学检查后并发症情况。结果300例患者经术后病理诊断,确诊周围型肺癌172例,构成比57.33%;172例周围型肺癌患者中,支气管镜、刷检液基细胞学,两者联合,B超经皮肺穿刺活检诊断为周围型肺癌的分别有113例、125例、112例、115例;在128例病理检查确诊为良性周围型肺部结节的患者中,支气管镜、刷检液基细胞学,两者联合,B超经皮肺穿刺活检诊断为周围型肺癌的分别有28例、32例、26例、27例;ROC结果显示,四种方式诊断周围型肺癌的AUC分别为0.609、0.705、0.752、0.760;300例经支气管镜联合刷检液基细胞学检查,均未发生感染、气胸等严重并发症,25例穿刺位置少量出血,32例发生轻微咳嗽,经对应处理后均显著好转。结论支气管镜联合刷检液基细胞学对周围型肺癌的早期诊断效能及安全性均较高,可有效减少漏诊及误诊。Objective To study the early diagnosis of peripheral lung cancer with bronchoscopy combined with brush liquid-based cytology.Methods From January 2018 to December 2019,300 patients with peripheral pulmonary nodular lesions in our hospital were selected for bronchoscopy,brush liquid-based cytology,and B-ultrasound percutaneous lung biopsy.The pathological diagnosis was used as the gold standard.The results of single and joint diagnosis of peripheral lung cancer were compared with the pathological diagnosis results.The receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value of the two.The complications of patients after bronchoscopy combined with brush liquid-based cytology were statistically analyzed.Results After the pathological diagnosis of 300 patients,172 cases of peripheral lung cancer were diagnosed,with a composition ratio of 57.33%.Among the 172 patients diagnosed with peripheral lung cancer by pathological examination,113 cases,125 cases,and 112 cases,115 cases were diagnosed with peripheral lung cancer respectively by bronchoscopy,brush liquid-based cytology,the combination of two inspection methods,and B-ultrasound percutaneous lung biopsy.Among the 128 patients diagnosed with benign peripheral pulmonary nodules by pathological examination,28 cases,32 cases,and 26 cases,27 cases were diagnosed with peripheral lung cancer respectively by bronchoscopy,brush liquid-based cytology,the combination of two inspection methods,and B-ultrasound percutaneous lung biopsy.ROC results showed that the AUCs of the four methods for diagnosing peripheral lung cancer were 0.609,0.705,0.752,0.760,respectively.In 300 cases of bronchoscopy combined with brush liquid-based cytology,no serious complications such as infection and pneumothorax occurred,25 cases had a small amount of bleeding at the puncture site,and 32 cases had a slight cough,which all improved significantly after corresponding treatment.Conclusion Bronchoscopy combined with brush liquid-based cytology has high efficiency and safe

关 键 词：周围型肺癌 支气管镜 刷检液基细胞学 早期诊断 

分 类 号：R734.2[医药卫生—肿瘤]