引用本文:于晓棠,李连宏,孙 雷,张 帆,范姝君,赵志英.纤维支气管镜检查中刷检及灌洗液对肺癌诊断的价值[J].大连医科大学学报,2009,31(5):576-579.
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纤维支气管镜检查中刷检及灌洗液对肺癌诊断的价值
于晓棠1, 李连宏1, 孙 雷1, 张 帆2, 范姝君1, 赵志英1
1.大连医科大学 病理与法医学教研室,辽宁 大连116044;2.大连医科大学 附属第二医院 普外二科,辽宁 大连116027
摘要:
[目的]探讨细胞学检查包括支气管刷片、灌洗液检查肺癌诊断中的诊断效价及应用价值。[方法]收集肺癌病例397例,纤支镜检查中分别采用活检、刷片及灌洗液取得组织和细胞学标本,制片作出病理诊断。[结果]诊断阳性率:组织学活检81.6%,纤支镜刷检66.8%,灌洗液29.2%。对比单独活检,活检结合刷检可以提高9.3%(P<0.001),活检结合灌洗液可提高6.5%(P<0.001),三者结合可将阳性率提高11.3%(P<0.001)。分型准确度:刷检和灌洗液显著低于组织活检(P<0.05),三者对小细胞癌的诊断准确度最高。[结论]纤支镜刷片、灌洗液与组织活检结合,可提高肺癌诊断阳性率,提高分型准确度,在肺癌诊断中具有极其重要的作用。
关键词:  纤维支气管镜  活检  刷检  灌洗液  肺癌
DOI:10.11724/jdmu.2009.05.19
分类号:R734.2
基金项目:
Evaluation of brushing and bronchial lavage examinations binding biopsy in diagnosis of lung cancer by bronchoscopy
YU Xiao-tang1, LI Lian-hong1, SUN Lei1, ZHANG Fan2, FAN Shu-jun1, ZHAO Zhi-ying1
1.Department of Pathology & Forensic Medicine, Dalian Medical University, Dalian 116044, China;2.Department of General Surgery, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
Abstract:
[Objective] The value of various diagnostic techniques including forcept biopsy, brushing and bronchial lavage follwing the fibreoptic bronchoscopy in the diagnosis of lung cancer were evaluated. [Methods] Flexible fibreoptic bronchoscopy was performed in 397 patients. Histological examination of specimens were obtained by forceps biopsy and cytological specimens were taken by brushing and bronchial lavage. [Results] Forceps biopsy specimens gave positive result in 81.6% of the cases, brushing in 66.8%, and the lavage in 29.2%. Addition to forcept biopay, brushing examination increased the sensitivity by 9.3% (P<0.001), and the bronchial lavage increased the sensitivity by 6.5% (P<0.001). The addition of both brushing and lavage increased the diagnostic yield of bronchoscopy by 11.3% (P<0.001). As to the pathological typing, the accuracy of brushing and lavage cytology is less than the biopsy (P<0.05).In all three methods, the diagnostic accuracy of small cell carcinoma was higher than other types of lung cancer. [Conclusion] These results indicate that cytological examinations including brushing and bronchial lavage can improve the efficiency of fibreoptic bronchoscopy in the diagnosis of lung cancer.
Key words:  bronchoscopy  biopsy  brushing  washing  lung cancer