经支气管镜冷冻活检在中央型肺癌中的诊断价值

目的探讨经支气管镜冷冻活检在中央型肺癌中的诊断价值及安全性。方法回顾性分析65例中央型肺癌患者,每例均经支气管灌洗、针吸活检、活检钳活检、毛刷刷检、冷冻活检。对冷冻活检与活检钳活检两种方法取得的组织大小、组织结构的完整性进行比较分析,并对所有取材方法的病理结果进行比较分析。同时观察各种取材方式的出血情况。结果活检钳活检组织平均大小为5.68mm~2,冷冻活检组织平均大小为12.35mm~2,冷冻活检组织明显大于活检钳活检;组织结构的完整性差异性不明显。冷冻活检的阳性检出率为83.08%,显著高于活检钳活检(P0.05)。对增生型及混合型肺癌,冷冻活检联合活检钳活检阳性率为98.46%。冷冻活检在浸润型病变中出血风险较大。结论在中央型肺癌中,冷冻活检联合活检钳活检,对增生型及混合型肺癌阳性率高,建议采用浸润型病变冷冻活检出血风险大,慎用。

Diagnostic value of transbronchoscopic cryorecanalization in central lung cancer

Objective To study the diagnosis and safety of transbronchoscopic cryorecanalization in central lung cancer. Methods 65 patients with central lung cancer, who received bronchial lavage, needle aspiration. for-ceps biopsy, bronchial brushing and cryorecanalization, were analyzed retrospectively. The size and structural integri-ty of the tissues from cryorecanalization and forceps biopsy were compared. All pathological results were compared. Meanwhile, hemorrhages caused by various methods were observed. Results The average size of the tissue in the forceps biopsy group was 5. 68 mm2, which was significantly smaller than that of 12. 35 mm2 in the cryorecanalization group, while the structural integrity of tissue had no significant difference between the two groups. The positive rate of central lung cancer by cryorecanalization was 83. 08%, which were significantly higher than that by forceps biopsy ( P<0. 05). The positive rate of proliferative lung cancer and mixed lung cancer was 98. 46% by cryorecanalization combined with forceps biopsy. Cryorecanalization increased the risk of bleeding. Conclusion Cryorecanalization combined with forceps biopsy has a higher positive rate in the diagnosis of central lung cancer, but cryorecanalization can increase the risk of hemorrhage.