多种技术联合应用对肺癌诊断的临床价值

Diagnostic value of lung cancer by diferent methods

目的评价多种技术联合应用对肺癌诊断的临床价值。方法 884例痰脱落细胞学、细菌学、常规支气管镜等检查均无阳性发现的疑似肺癌的患者行经支气管镜针吸活检术(TBNA)和活检刷检、经支气管镜超声引导针吸活检术(EBUS-TB-NA)、纵隔镜、超声或CT引导经皮肺穿刺活检术、PET-CT和内科电子胸腔镜胸膜活检术。结果 215例患者TBNA、刷检、活检的阳性率分别为81.58%、29.47%和16.84%。15例EBUS-TBNA的阳性率为91.67%,20例超声或CT引导经皮肺穿刺活检术阳性率为65%,10例PET-CT阳性率为80%,628例患者胸腔镜检查的总体阳性率为94.6%。结论多种技术联合应用可明显提高肺癌的早期诊断率。

Objective To evaluate the combination of different methods in diagnosis of lung cancer.Methods884 patients with suspicious lung cancer had negative results via exfoliative cytology,bacteriology and routine bronchoscopy.All these patients had transbronchial needle aspiration（TBNA） with biopsy and brushing,endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA）,mediastinoscopy,per cutem lung puncture needle aspiration under the guidance of type-B ultrasonic or CT,PET-CT and thoracoscopy.Results 215 patients were diagnosed by TBNA,biopsy and brushing.The positive rates were 81.58%,29.47% and 16.84%.15 patients by EBUS-TBNA with a positive rate of 91.67%,20 patients by per cutem lung puncture needle aspiration under the guidance of CT or type-B ultrasonic with a positive rate of 65%,10 patients by PET-CT with a positive rate of 80%,628 patients by electronic thoracoscopic biopsy and brushing with a positive rate of 94.6%.ConclusionThe combination of different methods significantly boost the rate of early diagnosis of lung cancer.