重复支气管镜检查在肺癌诊断中的价值

Value of repeated bronchoscopy in diagnosis of lung cancer

目的探讨重复支气管镜检查在肺癌诊断中的价值。方法回顾性分析155例接受重复支气管镜检并确诊为肺癌患者的临床病例资料。结果首次支气管镜检未能确诊的疑诊肺癌患者,接受重复支气管镜检并获得肺癌病理学确诊的重检阳性率为74.5%(155/208)。重检1次者为多,占91.0%(141/155),重检间隔时间以1周为多,占76.1%(118/155)。经支气管镜重检确诊肺癌的病例中,47.7%(74/155)的病例镜下表现为黏膜肥厚、凹凸或肿胀,为腔内新生物堵塞者占34.2%(53/155)。结论首次支气管镜检查结果与临床、X线,特别是镜下直视不符时,应进行重复支气管镜检,重复检查以1、2次为宜,并应尽早重检。综合运用各种镜下诊断技术有助于提高阳性率。

[ Objective ] To explore the value of repeated bronchoscopy in diagnosis of lung cancer. [ Methods ] Clinical data of 155 patients who received repeated bronchoscopy were analyzed retrospectively. [Results] In 208 patients 155 （74.5%） who received repeated bronchoseopy were diagnosed as lung cancer with pathological evidence. Of which, 141 patients （91.0%） received repeated bronchoscopy only once, and 118 patients （76.1%） received repeated bronchoscopy in a week, mucosa swelling was seen in 74 patients （47.7%） and intra-bronchial mass was seen in 53 patients （34.2%）. [Conclusion] Repeated bronehoscopy is recommended when initial pathological results are inconsistent with clinical manifestations, x-ray results, or especially morphological changes under endoscope. Once or twice more examinations may be an appropriate option, and it should be done as early as possible. The application of varied bronchoscope ：techniques may be helpful in improving positive rate.