径向超声引导经支气管镜冷冻肺活检联合肺泡灌洗在周围性肺癌诊断中的应用价值  

Application Value of Radial Endobronchial Ultrasound-Guided Transbronchial Lung Biopsy Combined with Bronchoalveolar Lavage in Diagnosing Peripheral Lung Cancer

作　　者：李广 刘勇[1] 刘岩[1] 张静静 雷鹏须 LI Guang;LIU Yong;LIU Yan;ZHANG Jingjing;LEI Pengxu(Respiratory Department,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院呼吸科,河南周口466000

出　　处：《河南医学研究》2025年第5期881-884,共4页Henan Medical Research

摘　　要：目的探讨径向超声引导(R-EBUS)经支气管镜冷冻肺活检(TBLB)联合肺泡灌洗(BAL)在周围性肺癌诊断中的应用价值。方法回顾性分析周口市中心医院2021年3月至2023年3月收治的84例周围性肺癌患者,分别进行R-EBUS TBLB检查与BAL检查,将活检标本以及灌洗液送至病理科进行细胞或组织学病理检查,并整理、分析、比较R-EBUS TBLB检查、BAL检查以及联合检查诊断周围性肺癌的效能。结果在84患者中,R-EBUS TBLB、BAL检查阳性率分别为48.81%(41/84)、63.10%(53/84)(P>0.05);联合检查阳性率为85.71%(72/84),高于单独检查(P<0.05)。联合组检出病灶直径<20 mm、20~60 mm患者阳性率高于BAL组、R-EBUS TBLB组(P<0.05);联合组上叶尖、背段病变检出阳性率高于BAL组、R-EBUS TBLB组(P<0.05);联合组腺癌、小细胞癌检出阳性率高于BAL组(P<0.05)。结论R-EBUS TBLB检查联合BAL检查可提高周围性肺癌诊断率,在不同病灶大小、病灶位置、肿瘤分型诊断中均具有优势,值得临床应用与推广。Objective To explore the application value of radial endobronchial ultrasound-guided(R-EBUS)transbronchial lung biopsy(TBLB)combined with bronchoalveolar lavage(BAL)in the diagnosis of peripheral lung cancer.Methods A total of 84 patients with peripheral lung cancer admitted to Zhoukou Central Hospital from March 2021 to March 2023 were retrospectively analyzed.R-EBUS TBLB examination and BAL examination were performed respectively.Biopsy specimens and lavage fluid were sent to department of pathology for cytoscopy or histopathological examination.The efficiency of R-EBUS TBLB examination,BAL examination and combined examination in the diagnosis of peripheral lung cancer was sort out,analyzed and compared.Results Among 84 patients,the positive rates of R-EBUS TBLB and BAL were 48.81%(41/84)and 63.10%(53/84)respectively(P>0.05).The positive rate of combined examination was 85.71%(72/84),which was higher than that of single examination(P<0.05).The positive rates of patients with lesion diameter<20 mm and lesion diameter of 20-60 mm were higher in combined group than those in BAL group and R-EBUS TBLB group(P<0.05).The positive detection rate of upper lobe tip and dorsal segment lesion in combined group was higher compared with that in BAL group and R-EBUS TBLB group(P<0.05).The positive detection rates of adenocarcinoma and small cell carcinoma were higher in combined group than those in BAL group(P<0.05).Conclusion R-EBUS TBLB examination combined with BAL examination can improve the diagnostic rate of peripheral lung cancer,and has advantages in the diagnosis of different lesion sizes,lesion locations and tumor types.

关 键 词：周围性肺癌 径向超声引导 经支气管镜冷冻肺活检 肺泡灌洗 阳性率 诊断 

分 类 号：R734.2[医药卫生—肿瘤]