经支气管镜细管吸引对肺癌、肺结核的诊断价值

目的探讨经支气管镜细管吸引法对肺癌、肺结核的诊断价值。方法回顾性分析2001年1月～2012年7月在昆明市第一人民医院行支气管镜检查的2079例患者中确诊为肺癌、肺结核患者的病理学、细胞学、细菌学检查资料。结果经支气管镜细管吸引法在确诊肺癌方面，阳性率高于灌洗法（Х^2=13．167，P=0．000）、钳取活检法（Х^2=5．090，P=0．021）及术后痰检（Х^2=12．713，P=0．000），与刷检法比较差异无统计学意义（Х^2=2．335，P=0．131）。在确诊肺结核方面，经支气管镜细管吸引法阳性率高于灌洗法（Х^2=123．683，P=0．000）、钳取活检法（Х^2=10．017，P=0．002）、刷检法（Х^2=49．682，P=0．000）及术后痰检（X。=91．642，P=0．000）。结论经支气管镜细管吸引可以提高肺癌、肺结核的诊断阳性率，且可以弥补一些位于肺亚段以下、特殊部位或常规支气管镜检查盲区病灶无法行钳取活检、刷检等的不足。

Diagnostic value of transbronchial tubule aspiration in lung cancer and tuberculosis

Objective To investigate the diagnostic value of transbronchial tubule aspiration in lung cancer and tuberculosis. Methods Pathology, cytology and bacteriology examination data of patients with lung cancer or tuberculosis among 2079 patients diagnosed by bronchoscopy in the First People＇s Hospital of Kunming City from January 2001 to July 2012 were analyzed retrospectively. Results In diagnosis of lung cancer, the positive rate of transbronchial tubule aspiration was higher than irrigation method （Х^2=13.167, P = 0.000）, forceps biopsy method （Х^2=5.090, P = 0.021） and postoperative sputum examination （Х^2=12.713, P = 0.000）, but there were no difference between transbronchial tubule aspiration and brush inspection method （Х^2=2.335, P = 0.131）. In diagnosis of pulmonary tuberculosis, the positive rate of transbronchial tubule aspiration was higher than irrigation method （Х^2=123.683, P = 0.000）, forceps biopsy method （Х^2-10.017, P = 0.002）, brush inspection method （Х^2=49.682, P = 0.000） and postoperative sputum examination （Х^2= 91.642, P = 0.000）. Conclusion Transbronchial tubule aspiration can improve the diagnosis positive rate of lung cancer and tuberculosis, and can make up the insufficient of protractor biopsy and brush located in subsegmental pulmonary, special-site and blind zone of conventional bronchoscopy.