经纤维支气管镜肺活检及刷检在肺部周围性占位病变诊断中的价值

目的评价经纤维支气管镜肺活检(transbronchiallung biopsy,TBLB)及刷检(brush biopsy,BB)对肺部周围性占位病变的诊断价值.方法回顾性分析186例X线或CT发现肺部周围性占位患者,经细胞学、组织病理及临床证实最终确诊为肺癌128例、结核31例、非特异性炎症及其它疾病27例,对其TBLB及BB结果进行分析,了解TBLB、BB病理取材方法的诊断阳性率.结果186例患者中采用TBLB、BB、TBLB BB对肺癌和肺结核的检出阳性例数和阳性率分别为,肺癌57(44.5%)、27(21.1%)、63(49.2%),结核13(41.9%)、7(22.6%)、15(48.4%).结论经纤维支气管镜肺活检及刷检对肺部周围性占位病变是安全、可靠、方便、经济并可重复进行的诊断方法.

Value of transbronchial lung biopsy and brush biopsy in the diagnosis of peripheral pulmonary nodules

Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB) and brush biopsy(BB) via fiberoptic bronchoscope for peripheral pulmonary nodules. Methods A total of 186 patients who presented with peripheral pulmonary nodules in chest radiography were proven with pulmonary carcinoma (n=128), pulmonary tuberculosis (n=31), and nonspecific inflammation or others (n=27) according to the examination of cytology, histology, and clinical evidence. Each patient received TBLB and BB via fiberoptic bronchoscope without fluoroscopic guidance. The clinical data and pathologic diagnosis were analyzed. Results The positive diagnosis rate of TBLB, BB and TBLB BB for pulmonary carcinoma was 44.5%, 21.1%, and 49.2%, for pulmonary tuberculosis was 41.9%, 22.6% and 48.4% respectively. Conclusion TBLB and BB in diagnosis of peripheral pulmonary nodules is a reliable, safe, handy and cheap, repeatable operation method.