经支气管肺灌洗结合CT定位行TBLB对周围型肺癌的诊断价值  

Diagnostic value of transbronchial lavage combined with CT localization of TBLB on peripheral lung cancer

作　　者：石芷男 刘卫庭 石媛娟 陈聪 SHI Zhinan;LIU Weiting;SHI Yuanjuan;CHEN Cong(Department of Respiratory and Critical Care Medicine,Shaoyang Hospital Affiliated to Nanhua University Hengyang Medical School,University of South China,Shaoyang 422000,China)

机构地区：[1]南华大学附属邵阳医院呼吸与危重症医学科,湖南邵阳422000

出　　处：《邵阳学院学报（自然科学版）》2023年第1期105-110,共6页Journal of Shaoyang University：Natural Science Edition

基　　金：湖南省科技创新计划项目(2020SK52002)。

摘　　要：目的探讨经支气管肺灌洗结合CT定位行经支气管镜肺活检(transbronchial lung biopsy,TBLB)对周围型肺癌的诊断价值。方法收集位于上叶前段、尖段、后段、下叶背段和后基底段病灶大小为1~3 cm的CT高度怀疑周围型肺癌的患者各60例,总计300例,各段随机抽取30名患者依据CT定位使用TBLB进行检查,另30名患者依据经支气管肺灌洗结合CT定位使用TBLB进行检查。所有最终入选患者经TBLB、经皮肺穿刺或手术标本等病理确诊为肺癌,比较两种定位方法下TBLB的诊断阳性率。结果300例患者中,269例确诊为肺癌患者纳入最终统计分析。CT定位组与经支气管肺灌洗结合CT定位组上叶前段、后段、下叶背段、后基底段的病灶TBLB诊断阳性率分别为25.0%与51.9%、24.1%与50.0%、29.6%与55.6%、24.0%与53.8%,差异有统计学意义(P值分别为0.038、0.040、0.049和0.028)。CT定位组和经支气管肺灌洗结合CT定位组上叶尖段的病灶TBLB诊断阳性率分别为30.8%与46.2%,差异无统计学意义(P=0.196)。结论经支气管肺灌洗结合CT定位行TBLB,可提高部分周围型肺癌的诊断阳性率。Objective To investigate the diagnostic value of lung lavage combined with transbronchial lung biopsy(TBLB)at CT localization for peripheral lung cancer.Methods A total of 300 patients with a high degree of suspicion of peripheral lung cancer on CT with lesions of 1 to 3 cm in size in the anterior,apical,posterior,dorsal,and posterior basal segments of the upper lobe were collected(n=60).Thirty patients were randomly selected from each segment for examination based on CT localization using TBLB and another 30 patients were examined based on lung lavage combined with CT localization using TBLB,and the diagnostic positivity rates of TBLB under the 2 localization methods were compared.Results Of the 300 patients,269 patients with a confirmed diagnosis of lung cancer were included in the final statistical analysis.For lesions in the anterior and posterior segments of the upper lobe,the dorsal segment of the lower lobe,and the posterior basal segment,the positive diagnostic rates of TBLB in the CT localization group and the lung lavage combined with CT localization group were 25.0%versus 51.9%;24.1%versus 50.0%;29.6%versus 55.6%;and 24.0%versus 53.8%,respectively,with statistically difference(P values were 0.038,0.040,0.049,and 0.028,respectively),For lesions in the apical segment of the upper lobe,the diagnostic positivity rate of TBLB was 30.8%versus 46.2%in the CT localization group and the lung lavage combined with CT localization group,respectively,with out statistically difference(P=0.196).Conclusion Lung lavage combined with bronchoscopic lung biopsy under CT localisation improves the positive diagnosis of peripheral types of lung cancer.

关 键 词：周围型肺癌 经支气管镜肺活检 经支气管肺灌洗 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R445[医药卫生—临床医学]