胸膜刷检联合活检在恶性胸腔积液诊断中的应用

The Study of Brush Biopsy of Pleural Biopsy Diagnosis of Malignant Pleural Effusion

目的探讨胸膜刷检联合活检在恶性胸腔积液诊断中的应用价值。方法对临床确诊的82例恶性胸腔积液病例进行胸膜活检、胸膜刷检和胸水细胞学检查,比较各种方法及其组合对肿瘤细胞的阳性率。结果单项检测阳性率以胸膜刷检最高(78.0%),高于胸水细胞学检查(62.2%)及胸膜活检(52.4%),差异有统计学意义(P<0.05)。胸膜活检和刷检联合检测阳性率为82.9%,与单独细胞学检测和胸膜活检相比差异有统计学意义(P<0.05),与单独胸膜刷检相比阳性率虽有增高,但差异无统计学意义(P>0.05)。如3种方法联合应用,阳性率为90.2%。结论胸膜活检和刷检联合应用能明显提高恶性胸腔积液的阳性率,是一种简单、安全、有效的方法,建议临床推广应用。

OBJECTIVE To evaluate the effects of brush biopsy of pleural biopsy diagnosis of malignant pleural effusion. METHODS Clinical diagnosis of 82 cases of malignant pleural effusion cases pleural biopsy, brush biopsy and pleural effusion cytology, compare various methods and combinations of the positive rate of tumor cells. RESULTS The positive rate of individual testing in order to pleural brushing the highest（78.0 percent）, higher than the pleural cytology（62.2%） and pleural biopsy（52.40%）, χ^2=0.62 difference was statistically significant（P〈0.05）. Pleural biopsy and brush biopsy positive rate of combined detection of 82.9 percent, with a separate cytology and pleural biopsy were statistically significant difference compared（P〈0.05 ）, with a separate pleural brushing compared to positive rate has increased, but the difference was not statistic significant （χ^2=0.62 ,P〉0.05 ）. Three kinds of methods such as the joint application, the positive rate was 90.2 percent. CONCLUSIONS Pleural biopsy and brush biopsy in combination can increase the malignant pleural effusion of the positive rate is a simple, safe and effective method, which should be suggested in chnical experiences.