纤维支气管镜检查技术在周围型肺癌病理诊断中的应用评价

目的: 评价纤维支气管镜检查技术在周围型肺癌病理诊断中的应用价值.方法: 对105例周围型肺癌病例进行经纤维支气管镜病变部位盲检、毛刷直接涂片和毛刷涮洗物新柏氏TCT组织和细胞病理检查.结果: 1.盲检法病理阳性53例(50.5%), 毛刷法41例(39.0%), 新柏氏TCT法33例(31.4%)(P＜0.05); 联合三种方法病理阳性68例(64.8%),其中单独盲检法阳性12例,单独毛刷法阳性2例,单独新柏氏TCT法阳性2例.2.一次纤维支气管镜检查92例,病理阳性66例(62.9%);两次检查9例,病理阳性2例;三次检查4例,病理阳性0例.3.并发症有出血((50ml)61例(58%)、气胸7例(6.7%)、血胸1例(0.9%).结论:盲检法明显优于毛刷法和新柏氏TCT法.三种方法联合应用不能提高阳性检出率,但可以提高病理阳性检出例数.多次纤维支气管镜检查不能提高累积阳性率,但可以提高病理阳性检出例数.

EVALUATION OF VARIOUS CYTOLOGICAL/HISTOLOGICAL EXAMINATIONS BY FIBREOPTIC BRONCHOSCOPY IN THE DIAGNOSIS OF PERIPHERAL LUNG CANCER

Objective: To evaluate the value and safety of variocs cytological/histological examinations by fibreoptic bronchoscopy in the diagnosis of peripheral lung cancer. Methods: Histological examination of specimesobtained blindly by forceps biopsy and cytological examinations collected by brushing and selective bronchial lavage for Thinprep system analysis were evaluated for diagnostic power in 105 cases of peripheral lungng cancer.Results: 1.of 105cases,53 cases(50.5%)were pathologically identified iedlung cancer by blindforceps biopsy, 41cases(39.0%)by brushing smears,33cases(31.4%)byThinprep systen analysis(P<0.05).Among the total of 68 cases pathologically confirmed,12 cases were exclusively confirmed by blind forceps biopsy,2bcasesbybhre exclusively confirmed by blind forceps biopsy,2cases by brushing smears, by Thinprep system analysis.2.of 105 cases,92 cases were subjected to fibreoptic bronchoscopy examination once and 66 cases(62.9%)confirmed.9 casesto twice and 2 cases confirmed,4cases to thirdly and 0 case confirmed.3.Major complications were hemoptysis(58%),pneumothroax (6.7%)and hemothorax (0.9%).Conclusions: As a technique,blind forceps biopsy is superior to brushing smear orTCT anailysis.Combination of tree techniques do not improve in positive detection rate,but the number of cases confirmed accrued.More than one thime fibreoptic bronchoscopy examination do not improve in positive detection rate,but the number of cases confirmed also accrued.