摘要
目的 :评价纤维支气管镜检查技术在周围型肺癌病理诊断中的应用价值。方法 :对 1 0 5例周围型肺癌病例进行经纤维支气管镜病变部位盲检、毛刷直接涂片和毛刷涮洗物新柏氏 TCT组织和细胞病理检查。结果 :1 .盲检法病理阳性 5 3例 (5 0 .5 % ) ,毛刷法 4 1例 (39.0 % ) ,新柏氏 TCT法 33例(31 .4 % ) (P<0 .0 5 ) ;联合三种方法病理阳性 6 8例 (6 4.8% ) ,其中单独盲检法阳性 1 2例 ,单独毛刷法阳性 2例 ,单独新柏氏 TCT法阳性 2例。 2 .一次纤维支气管镜检查 92例 ,病理阳性 6 6例 (6 2 .9% ) ;两次检查 9例 ,病理阳性 2例 ;三次检查 4例 ,病理阳性 0例。3.并发症有出血 ((5 0 ml) 6 1例 (5 8% )、气胸 7例 (6 .7% )、血胸 1例 (0 .9% )。结论 :盲检法明显优于毛刷法和新柏氏 TCT法。三种方法联合应用不能提高阳性检出率 ,但可以提高病理阳性检出例数。多次纤维支气管镜检查不能提高累积阳性率 。
Objective: To evaluate the value and safety of variocs cytological/histological examinations by fibreoptic bronchoscopy in the diagnosis of peripheral lung cancer. Methods: Histological examination of specimesobtained blindly by forceps biopsy and cytological examinations collected by brushing and selective bronchial lavage for Thinprep system analysis were evaluated for diagnostic power in 105 cases of peripheral lungng cancer.Results: 1.of 105cases,53 cases(50.5%)were pathologically identified iedlung cancer by blindforceps biopsy, 41cases(39.0%)by brushing smears,33cases(31.4%)byThinprep systen analysis(P<0.05).Among the total of 68 cases pathologically confirmed,12 cases were exclusively confirmed by blind forceps biopsy,2bcasesbybhre exclusively confirmed by blind forceps biopsy,2cases by brushing smears, by Thinprep system analysis.2.of 105 cases,92 cases were subjected to fibreoptic bronchoscopy examination once and 66 cases(62.9%)confirmed.9 casesto twice and 2 cases confirmed,4cases to thirdly and 0 case confirmed.3.Major complications were hemoptysis(58%),pneumothroax (6.7%)and hemothorax (0.9%).Conclusions: As a technique,blind forceps biopsy is superior to brushing smear orTCT anailysis.Combination of tree techniques do not improve in positive detection rate,but the number of cases confirmed accrued.More than one thime fibreoptic bronchoscopy examination do not improve in positive detection rate,but the number of cases confirmed also accrued.
出处
《承德医学院学报》
2004年第2期114-116,共3页
Journal of Chengde Medical University
关键词
纤维支气管镜
周围型肺癌
病理
lung cancer
diagnosis
fibreoptic bronchoscopy
