经纤维支气管镜联合取材的病理学检查对肺癌诊断的价值分析

EVALUATION OF DIAGNOSTIC VALUE OF PULMONARY CARCINOMA VIA FIBROBRONCHOSCOPE ALLIED PATHOLOGIC SAMPLING GETTING SPECIMEN IN MANIFOLD WAY

目的:探讨经纤维支气管镜(简称纤支镜)联合多种取材方法对肺癌诊断的价值。方法:采用回顾性分析方法,对439例经病理组织学及细胞学确诊为肺癌的纤支镜检查结果进行统计分析,了解钳取活检、刷片、针吸活检(TBNA)和支气管肺泡灌洗液(BALF)四种不同取材方法对肺癌诊断阳性率的价值。结果:单纯钳取、单纯刷片、单纯TBNA、钳取+刷片、钳取+TBNA、刷片+BALF、钳取+刷片+BALF、钳取+刷片+BALF+TBNA的阳性率分别为80.24%、78.77%、80.79%、86.26%、87.26%、86.22%、93.14%和95.65%。联合取材阳性率明显高于单一取材(P<0.05)。结论:根据肺癌大体形态和镜下特点的不同采取不同经纤支镜取材方法,联合多种取材方法可提高肺癌的病理学诊断率。

Objective： To discuss diagnostic value of pulmonary carcinoma via fiberbronchoscope allied pathologic sampling getting specimen in manifold way.Methods： To analysis retrospectively the results of 439 cases of pulmonary carcinoma diagnosed by fiberbronchoscope biopsy and cytology, and to understand the value of diagnostic positive rate among forceps biopsy , brush cytology , transbronchial needle aspiration （TBNA） and bronchoalveolar lavage fluid （BALF）. Results： The positive rate of simple forceps biopsy , simple brush cytology, simple TBNA , forceps biopsy and brush cytology ,forceps biopsy and TBNA, brush cytology and BALF, forceps biopsy and brush cytology and BALF,forceps biopsy and brush cytology and BALF and TBNA was respectively at 80.24%, 78.77%, 80.79%, 86.26%, 87.26%, 86.22%, 93.14% and 95.65%. The positive rate of sampling in manifold way was obviously higher than simple way（P〈0.05）.Conclusion： It can increase the positive rate of diagnosing pulmonary carcinoma via fibrobronchoscope to get specimen in different way according to the different pulmonary carcinoma and allied pathologic sampling in manifold way.