纤维支气管镜下液基细胞学检测诊断肺癌的临床价值

目的 探讨纤维支气管镜下液基细胞学检测对肺癌患者的诊断效果,为肺癌的早期诊断提供可参考依据.方法 选取万宁市人民医院呼吸内科2014年1月至2016年12月收治的300例初步怀疑肺癌的患者作为研究对象,详细记录患者信息,所有患者均行纤维支气管镜下液基细胞学检测,以术后病理结果为金标准,评价液基细胞学检测对肺癌患者的诊断价值.结果 液基细胞学诊断肺癌的灵敏度为78.1%(86/110),特异度为94.4%(85/90),诊断符合率为83.0%.液基细胞学诊断鳞癌的灵敏度为94.9%(74/78),特异度为97.7%(129/132),诊断符合率为96.7%;诊断腺癌的灵敏度为94.3%(66/70),特异度为97.1%(136/140),诊断符合率为96.2%;诊断大细胞癌的灵敏度为78.6%(11/14),特异度为99.5%(195/196),诊断符合率为98.1%;诊断小细胞癌的灵敏度为78.9%(30/38),特异度为98.3%(169/172),诊断符合率为94.8%;诊断未分型癌的灵敏度为70.0%(7/10),特异度为94.5%(189/200),诊断符合率为93.3%.结论 纤维支气管镜下液基细胞学检测是一种简便、可靠的肺癌诊断方法,且对不同肺癌分型亦有较高的诊断特异度及准确性.

Clinical value of liquid based cytology test with fiberoptic bronchoscopy in the diagnosis of lung cancer

Objective To study the value of liquid based cytology test of brushing specimens obtained via fi-beroptic bronchoscopy for the diagnosis of lung cancer. Methods A total of 300 patients with suspected lung cancer who were treated in our hospital from January 2014 to December 2016 were selected as subjects. All patients were fol-lowed up for bronchoscopic liquid-based cytology, and the postoperative pathologic results were used as gold standard. The diagnostic value of liquid-based cytology in patients with lung cancer was evaluated. Results The sensitivity of liq-uid-based cytology to diagnose lung cancer was 78.1%(86/110), and the specificity was 94.4%(85/90), with the coinci-dence rate of 83.0%. The sensitivity, specificity, and diagnostic coincidence rate were 94.9%(74/78), 97.7%(129/132), 96.7%for adenocarcinoma, 94.3%(66/70), 97.1%(136/140), 96.2%for adenocarcinoma, 78.6%(11/14), 99.5%(195/196), 98.1%for large cell carcinoma, 78.9%(30/38), 98.3%(169/172), 94.8%for small cell carcinoma, 70.0%(7/10), 94.5%(189/200), 93.3%for undifferentiated carcinoma. Conclusion Liquid based cytology test with fiberoptic bronchoscopy can significantly improve the detection rate of lung cancer, and have a high specificity and accurate rate of subtyping. It is an effective tool for the diagnosis and subtyping of lung cancer.