经支气管针吸活检与经支气管活检对中央型肺癌的诊断价值

目的 研究经支气管活检（TBB）与经支气管针吸活检（TBNA）两种方法对中央型肺癌的诊断价值.方法 2011年1月至2012年10月在我院行手术治疗的中央型肺癌患者150例,就诊后均先行TBNA、再行TBB.回顾性分析两种方法的诊断结果.结果 150例中央型肺癌患者中腔内肿块型33例,TBB确诊33例（100％）,TBNA确诊32例（97.0％）,差异无统计学意义（P=0.90）；单纯管腔狭窄型26例,TBB确诊1例（3.9％）,TBNA确诊26例（100％）,差异有统计学意义（P=0.01）；管腔外压型16例,TBB确诊2例（12.5％）,TBNA确诊16例（100％）,差异有统计学意义（P=0.02）；管腔狭窄合并黏膜弥漫病变型47例,TBB确诊25例（53.2％）,TBNA确诊40例（85.1％）,差异有统计学意义（P=0.04）；混合型28例,TBB确诊27例（96.4％）,TBNA确诊28例（100％）,差异无统计学意义（P=0.87）.结论 针对中央型肺癌不同的气管镜下表现,准确合理选择活检方法可以在保证诊断阳性率的前提下最大限度地降低检查费用,达到最佳效价比.

Significance of transbronchial needle aspiration and transbronchial biopsy in the diagnosis of central lung cancer

Objective To investigate the diagnostic value of transbronchial needle aspiration （TBNA） and transbronchial biopsy（TBB） in central lung cancer.Methods Retrospectively analyzed the diagnostic data of 150 patients with central lung cancer who underwent TBNA followed by TBB in our hospital from January 2011 to October 2012.Results Among 150 patients with central lung cancer,33 cases had intracavity mass.Thirtythree cases （100％） were confirmed by TBB and 32 cases （97.0％） confirmed by TBNA.There was no statistically significant difference between the diagnosis of TBB and TBNA（P =0.90）.There were 26 cases with simple stenosis,among which 1 case（3.9％） confirmed by TBB and 26 cases（100％） confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA （P =0.01） Sixteen cases belonged to the lumen external pressure type with 2 cases（12.5％） were confirmed by TBB and 16 cases（100％） confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA （P =0.02）.Forty-seven cases had luminal stenosis combined with mucosal diffuse lesions with 25 cases（53.2％） confirmed by TBB and 40 cases（85.1％） confirmed by TBNA.And there was statistical difference was observed between the diagnosis of TBB and TBNA（P =0.04）.Twenty-eight cases had mixed type central lung cancer with 27 cases（96.4％） confirmed by TBB and 28 cases（100％） confirmed by TBNA.No statistically significant difference was observed between the diagnosis of TBB and TBNA （P =0.87）.Conclusion According to endoscopic performance of central lung cancer,accurate and reasonable choice of biopsy method can minimize inspection costs on the basis of maintaining positive rate of diagnosis in order to achieve optimal titer.