纤维支气管镜检查中央型肺癌246例分析

对２４６例中央型肺癌行纤支镜检查，结果显示：肿瘤均位于段及段以上支气管。右肺６１％，左肺３９％，两肺上叶４６．３％，两肺下叶２８％。病理类型为鳞癌５６．１％，小细胞癌２８％，腺癌１４．６％。纤支镜下主要特征为：鳞癌以管内增殖型改变（７１％）为主，表现为肿物向腔内生长，常伴管腔阻塞；小细胞癌和腺癌以浸润型改变和间接征象明显，小细胞癌常表现为局部粘膜增厚，管腔不同程度狭窄，组织脆，易出血等；腺癌多为息肉型，阻塞管腔。１２例胸片及ＣＴ阴性者，仅见局部粘膜色泽异常或粘膜粗糙。复检纤支镜可提高早期肺癌诊断率。

Fiberobronchoscopic Findings in 246 Cases of Central Type or Lung cancer

Two hundred and forty-six patients with central type of lung cancer were examined with fiberobronchoscopy.All the neoplasms were situated at the level of segmental lobular bronchi and centripetally.61% of the tumors were located in the right lung and 39% on the left.Upper lobes hosted 46.4% of the lesions and the lower lobes harboured 28% of the tumors.Pathologically three types were recognized,they were squamous cell carcinoma(56.1%),small cell carcinoma(28%)and adenocarcinoma(14.6%).Squamous cell carcinoma usually appeared as exophytic growth and tended to block the bronchial lumen.On the otherhand,small cell carcinoma and adenocarcinoma were prone to infiltration.Endoscopically the former usually presented as local overgrowth of the mucous membrance and the bronchial lumen in turn was narrowed;the latter was polypoid in form.And,the discoloration and roughness of the local mucous membrance appeared in 12 of them whose chest film and CT scan were negative for signs of cancer.It is concluded that repeated bronchoscopic examination may improve early diagnosis of the lung can cer.