刷检、肺穿细胞学及肿瘤标志物对肺癌的诊断价值

目的探讨纤维支气管镜刷检与CT下肺穿刺细胞学对肺癌及其分型的诊断价值。方法对331例患者纤维支气管镜、肺穿涂片,进行瑞-吉氏染色、检验,对结果进行统计、分析,并记录其病理学结果 ,同时对肿瘤标志物CEA、CYFRA21-1、NSE进行检测。结果 331例中肺癌患者140例,细胞学诊断结果敏感性为85.7%,特异性为88.2%,符合率85.7%,其中肺腺癌78.9%,肺鳞癌64.3%,小细胞癌87.1%。肺腺癌肿瘤标志物CEA与对照组、鳞癌组及小细胞癌组比较（P〈0.05）有显著性差别。肺小细胞癌肿瘤标志物NSE与腺癌组、鳞癌组及对照组比较（P〈0.05）有显著性差别。结论纤维支气管镜与肺穿刺细胞学检查对肺癌的诊断及分型具有较高的临床价值。肿瘤标志物CEA、NSE对肺腺癌及小细胞癌的诊断、治疗及预后观察有一定临床价值。

The diagnostic value of brush biopsy,lung puncture cytology and tumor marker with lung cancer

Objective This essay discusses the diagnostic value of fibreoptic bronchoscopy brushing and lung puncture cytology under CT of lung cancer and its typing.Methods The fibreoptic bronchoscopy brushing and lung needle smear of 331 patients is processed with Wright-Giemsa staining and examined.The checking result is counted and analysed,with the pathologic results recorded,and the tumor marker CEA、CYFRA21-1 and NSE are also examined.Results There were 140 lung cancer patients out of the total 331 patients,whose sensitivity of the cytological diagnositic result is 85.7%,specificity is 88.2%,the accordance rate of lung cancer is 85.7%,of which lung adenocarcinoma 78.9%,squamous carcinoma 64.3%,anaplastic carcinoma 87.1%.In comparison with control group squamous carcinoma group and anaplastic carcinoma group（P0.05）,the adenocarcinomatous tumor marker CEA has a prominent difference.The SCLC tumor marker NSE,in comparison with adenocarcinoma group squamous carcinoma group and control group（P0.05）,has a prominent difference.Conclusion fibreoptic bronchoscopy brushing and lung puncture cytologic biopsy of lung cancer diagnosis has a higher value.Tumor marker CEA、NSE have a certain clinic value in the diagnosis therapy and observation after curing.