肺癌癌性空洞纤维支气管镜检查分析

目的：探讨纤维支气管镜（纤支镜）对肺癌癌性空洞的诊断价值。方法：回顾性分析27例肺癌癌性空洞的纤支镜检查情况，结果：27例中鳞癌17例，腺癌2例，腺鳞癌1例，大细胞癌1例，未能分型6例，纤支镜检查确诊21例，阳性率77．8％，镜下表现，新生物型4例，粘膜浸润型12例，外压型3例，大致正常型8例，4例新生物型直视下活检均阳性，刷检3例阳性，7例粘膜浸润型直视下活检阳性2例，刷检阳性3例，其中1例活检刷检均阳性，纤支镜检查阳性率57．1％（4／7），余16例中经支气管肺活检阳性11例，经支气管刷检阳性6例，其中4例活检刷检均阳性，阳性率81．3（13／16），结论：纤支镜检查对肺癌癌性空洞的确诊率高，应予重视，对镜下未见新生物者，应积极采用经支气管肺活检及经支气刷检。

The Value of Fiberoptic Bronchoscopy in Diagnosis of Carcinomatous Cavity of Lung Cancer

Objective: To assess the diagnostic value of fiberoptic bronchoscopy for carcinomatous cavity of lung cancer. Methods: The outcome of bronchoscopy in 27 cases of lung cancer with carcinomatous cavity was analyzed retrospectively. Results: 27 patients included 17 squamous carcinomas, 2 adenocarcinomas, 1 adenosquamous carcinoma, 1 large cell carcinoma, and 6 unable to be classified. 21 patients were definitely diagnosed by fiberoptic bronchoscopy (77.8%). The main endoscopic findings were tumor in 4 cases, infiltration in 12 cases, compression in 3 cases, normal in 8 cases. The positive rate of bronchial biopsy plus brushing was 100% to tumor type (4/4), 57.1% to infiltration type (4/7). To other 16 patients, the total positive rate of transbronchial biopsy and transbronchial brushing was 81.3% (13/16). Conclusions: Fiberoptic bronchoscopy is vital in the diagnosis of carcinomatous cavity of lung cancer. Transbronchial biopsy and transbronchial brushing are the main means to increase diagnostic rate.