TBLB联合细胞学检查对肺周围孤立性肿块的诊断价值

目的：探讨非直视经纤支镜肺活检（TBLB）联合多种细胞学检查对肺周围孤立性结节或肿块的诊断价值。方法：对我院近年来114例行非直视TBLB（简称盲检）并最终经病理学检查并确诊的肺周围孤立性结节或肿块患者的临床资料进行回顾性分析。结果：114例患者中诊断为癌症97例（癌症组），非癌症17例（非癌症组）。癌症组中各种方法诊断阳性率分别为TBLB55．7％、支气管肺泡灌洗液（BALF）45．4％、支气管刷片36．1％、痰检35．1％；4项方法联合诊断阳性率为69．1％。结论：盲检联合BALF、支气管刷片及痰检对诊断周围型肺癌有较高的阳性率，但对非癌症病变诊断价值不大。

Diagnosis value of TBLB combined with cyologic examination on peripheral lung tumor

Objective： To investigate the clinical diagnosis value of blind transbronchial lung biopsy （TBLB） combined with kinds of cytologic examination in peripheral lung nodules or mass. Methods： A retrospective analysis was done in 114 patients who had finished the blind TBLB for the peripheral lung nodules or mass and clarified the diagnosis by pathology. Results： Among the 114 patients, 97 patients were diagnosed as cancer （cancer group）and 17 patients were not diagnosed as cancer（ no cancer group）. In cancer group, the diagnostic certainty of TBLB was 55.7% ; bronchoalveolar lavage fluid（BALF） was 45.4% ; fiberbronchoscopic brushing was 36.1% ; sputum examination was 35.1%. Uniting to the four methods increased the diagnostic rate to 69.1%. Conclusion： TBLB combined with BALF, fiberbronchoscopic brushing and sputum examination have a high diagnosis rate for peripheral lung cancer, but they are no significance of the nontumorous lesion.