100例中央型肺癌纤支镜形态特征与胸部CT及病理对照分析

目的 提高纤支镜检查和胸部ＣＴ检查对中央型肺癌诊断的意义。并探讨它们之间与理类型的关系。方法 分析１９９５年１０月至１９９７年６月中央型肺癌１００例的临床资料，所有病例均行纤支镜检查和胸部ＣＴ检查。检查间隔时间不超过一周并与病理类型比较。结果 中央型肺癌１００例，男性６１例，女性３９例；其中鳞癌４６例，腺癌２７例，鳞腺产吕８例，小细胞癌４例，肺泡癌３例，示能分型１２例。纤支镜直接征象：鳞癌８４.78%(39/46)，腺癌７４.07%（２０／２７）,磷腺癌７５％（６／８），肺泡细胞癌６６.67%(2/3)，小细胞癌５０％（２／４），未能分型６６.67%(8/12)，间接征象：腺癌２５.93%(7/27)，鳞癌１５.22%(7/46)，鳞腺癌２５％（２／８），小细胞癌５０％（２／４），未能分型３３.33%(4/12)。ＣＴ检查发现异常９７例，只有２例ＦＯＢ检查镜下未见异常，ＣＴ发现支气管狭窄、阻塞、截断，支气腔内有肿块影为２２％（２２／１００）。结论 中央型肺癌以男性多见，病理类型多为鳞癌，ＣＴ与纤支镜检查各有长处，ＦＯＢ能直接见到气管内的病变，并钳取组织检查获病理，但很难进入较小支气管，ＣＴ检查能发现块影形态以及纵隔肺门淋巴结肿大，两者结合能提高中央型肺癌的诊断水平。

The Comparison of the Morphology by FB and Chest CT with Pathology in 100 Cases with Central Lung Carcinoma

Objective:To improve the diagnostic significance of the central lung cancer by fiberbronchoscope(FOB)and chest CT and study the relationship between the diagnostic results and their pathological types.Methods：The clinical data of 100 cases of the central lung cancer collected from oct.1995 to Jun.1997,was analysed by fiberbronchoscopy and CT within a weeks interval,and made a comparison between their results and pathological types.Results:The pathological findings showed that,of 100 cases(61 males,39 females),46 cases were squamous cell carcinoma,27 adenocarcinoma,8 mixed squamo-adenocarcinoma,4 small cell lung cancer,3 pulmonary alveolar carcinoma and 12 unidentified type.The fiberbronchoscopic direct symptom showed the squamous cell carcinoma was 84.78%(39/46)，the adenocarcinoma was 74.07%(20／27),the squamo-adenocarcinoma was 25%(2/8),the pulmonary alveolar carcinoma was 66.67%(2/3),the small cell lung cancer was 50%(2/4),the unidentified type was 66.67%(8/12).The fiberbronchoscopic indirect symptom showed the adenocarcinoma was 25.93%(7/27),the squamous cell carcinoma was 15.22%(7/46),the squamoadenocarcinoma was 25%(2/8),the small cell lung carcinoma was 50%(2/4)and the the unidentified type was 33.33%(4/12).97 abnormal cases were found by CT and only 2 cases were normal by FOB.CT results indicated that the bronchus appeared narrow,occlusion and interuption.22 cases appeared mass shadow in bronchus.Conclusion：Most of the central lung carcinoma in which pathological type was the squamous cell carcinoma,appeared in male.Two examines have their good quality,i.e.the disease in bronchus could be directly found and analysed pathologically by FOB,which was difficult to be entered to the small bronchus.The shape of mass shadows and the swelling of the mediastinum Lymph nodes could be observed by CT.The above-mentioned results showed the diagnostic level of the central lung carcinoma was raised by combining with two methods.