经纤维支气管镜不同取材方法对肺癌的诊断的影响

目的探讨纤维支气管镜不同取材方法对肺癌的诊断影响。方法2002年至2004年间我院门诊及病房疑诊肺癌行纤维支气管镜检查患者76例,采用钳检/TBLB、刷检、针吸活检(TBNA)等方法获取标本,经病理学或细胞学检查确诊。结果76例确诊为肺癌66例,其中腔内增生型93.9%(31/32),管壁浸润型86.4%(19/22),管外压迫型75.0%(9/14),中央型88.0%(59/67)周围型66.7%(6/9),刷检、TBNA阳性率分别是53.4%(41/76)、78.1%(50/64)、58.8%(20/34),联合三种取材方法阳性率90.8%(69/76);结论纤维支气管镜检查对肺癌的诊断率与病变生长方式、部位、取材方式、技术等有密切关系,联合取材能提高肺癌的诊断率。

Value of using fibrobronchoscope of different sample-selected methods in diagnosis of lung cancer

Objective To evaluate diagnostic value of using fibrobronchoscope of different sampling methods in diagnosis of lung cancer. Methods Seventy-six suspected lung cancer inpatients and outpatients in our hospital during years of 2002 through 2004 were examined by fibrobronchoscope. The ways of sample selection conducted included brush biopsy, transbronchial lung biopsy (TBLB) and transbronchial needle aspiration (TBNA). Results The positive rates of proliferation lesson, infiltration lesson and compression lesson were, respectively, 93.9%, 86.4% and 75.0%. the positive rates of protractor biopsy/TBLB, brushing biopsy, TBNA were, respectively, 78.1%, 53.4% and 58.8%. The positive rates using the above-mentioned three methods combined was 90.8%. Conclusion Fibrobronchoscope using different biopsy methods is useful and safe. The positive rate of diagnosing lung cancer can be improved if a combined sample-selection method is used.