支气管肺泡灌洗液细胞染色体与癌胚抗原联合检测对肺癌的诊断价值

目的探讨支气管肺泡灌洗液中细胞染色体与癌胚抗原（CEA）检测对肺癌的临床诊断价值。方法98例肺部疾病患者分为肺癌组52例和良性肺部疾病组46例。应用纤维支气管镜进行支气管肺泡灌洗，收集其灌洗液进行细胞染色体检测，并应用放射免疫法测定其中CEA含量，最后进行统计学处理。结果肺癌组支气管肺泡灌洗液细胞染色体检查发现数目异常达90．38％，而良性肺部疾病组细胞染色体异常仅4．35％，2组阳性率比较有统计学意义（P〈0．01），若同时观察细胞核情况，肺癌组就有92．31％染色体检出异常，显著高于细胞病理学检查（阳性率仅71．15％，P〈0．01），也明显高于CEA检测（阳性率仅57．69％，P〈0．01），同时检查3项指标敏感性达94．23％，特异性为84．78％，诊断准确性为89．80％。结论检测支气管肺泡灌洗液中的细胞染色体结构及数目，CEA含量，并结合细胞病理学检查，对诊断及鉴别诊断肺癌有重要的参考价值，尤其对周围型肺癌的价值更大，临床操作安全、耐受性好，值得临床推广应用。

Diagnostic value of combined chromosome examination and carcinoembryonic antigent in the blonchoalveolar lavage fluids for lung cancer

Objective To study the diagnostic value of the chromosome and Careinoembryonic antigent （CEA） in the Blonehoalveolar Lavage Fluids （BALFs） for lung cancer. Methods Fifty two eases were enrolled in the lung cancer group, with 46 of benign lung disease as the control group, Flexible fiberoptie bronehoscopy was adopted and the BALFs were collected in each group, for CEA and chromosome measurement. Results 90. 3% of the chromosomes in BALFs of lung cancer group were abnormal, while the percentage in control group was 4. 4% only, showing a significant difference. If nucleus was examined at the same time, 92. 3% of the chromosomes in lung cancer group was abnormal, which was significantly higher than that of the eytopathologieal examination （71.1%） and CEA （57. 7% ）. If CEA, chromosome and carcinoma cell exams were jointly applied, 94. 2% of lung cancer patients would be positive to at least one of the three tests. The accuracy was 89. 8%, Conclusion The fibro - bronehoseope must be adopted in suspicious lung cancer patients, especially in periphery lung cancer. Exams of chromosome, CEA and eytopathology in the BALFs have a very important role in the diagnosis and differential diagnosis of lung cancer, especially periphery lung cancer, Meanwhile, as a safe and less invasive technique, Bronehoalveolar Lavage is recommended for more clinical application.