纤维支气管镜下联合取材对肺癌的诊断价值(附266例报告)

Diagnostic value of combined bronchofibroscopic biopsy in lung carcinoma (266 cases)

目的评价纤维支气管镜下联合取材方法对肺癌的诊断价值。方法回顾性分析266例肺癌患者的纤维支气管镜检查结果,比较钳夹、刷检、灌洗及联合取材方法诊断肺癌的阳性率。结果3种不同取材方法对肺癌诊断的阳性率分别为:钳夹80.85%、刷检71.03%、灌洗59.40%,组间比较差异有统计学意义(χ2=27.53,P<0.01);联合取材法对肺癌诊断的阳性率分别为:钳夹+刷检87.61%、钳夹+刷检+灌洗93.36%,高于任何单一的取材法,差异有统计学意义(P<0.05),钳夹+刷检+灌洗联用略优于钳夹+刷检联用,差异有统计学意义(P<0.05)。结论纤维支气管镜下联合取材可提高对肺癌诊断的阳性率。

[Objective] To assess the role of the combined bronchofibroscopie biopsy in the diagnosis of lung carcinoma. [Methods] The positive rates of ring clamp biopsy, brush biopsy, bronchial-alveolar lavage and the combined bronchofibroscopic biopsy in the diagnosis of lung carcinoma were comparatively analyzed by means of retro- spective analysis on the bronchofiberscopic results of 266 patients with lung carcinoma. [Results] In the diagnosis of lung carcinoma,the positive rates of the 3 bioptic methods including ring clamp biopsy, brush biopsy and bronchial- alveolar lavage were 80.85%, 71.03% and 59.40%, respectively. There was significant difference among them by group comparison （Χ^2=27.53, P 〈0.01）. The positive rates of the combined bronchofibroscopic biopsy were as follow： that of ring clamp biopsy combined with brush biopsy was 87.61%, and that of ring clamp biopsy, brush biopsy combined with bronchial-alveolar lavage was 93.36%, which were higher than any simple bioptic method with statistically significant difference （P 〈0.05）. The positive rate of ring clamp biopsy combined with brush biopsy was shghtly lower than that of ring clamp biopsy, brush biopsy combined with bronchial-alveolar lavage with statistically significant difference （P 〈0.05）. [Conclusion] The positive rate in the diagnosis of lung carcinoma can be increased by the combined bronchofibroscopic biopsy.