无X线透视下支气管镜肺活检对周围型肺癌的诊断作用研究

The research for no X-ray perspective by bronchoscopic lung biopsy in the diagnosis of peripheral lung cancer

目的探讨无X线透视下支气管镜肺活检对周围型肺癌的诊断作用。方法选择2011年1～12月期间在我院病房和门诊就诊的50例常规支气管镜检查未发现腔内病变的周围型病变患者,在无X线透视下按胸部CT影像学解剖定位,经电子支气管镜对肺部周围性病变进行肺活检术(TBLB)。结果经支气管镜肺活检诊断确诊15例,其阳性率为30%(15/50)。根据CT显示周围型肺癌不同病灶大小,与支气管镜活检诊断阳性率比较,差异有统计学意义(P<0.05)。男性患者TBLB阳性率明显高于女性,病理类型中腺癌8例,鳞癌4例,大细胞癌2例,小细胞癌1例,腺癌的阳性率明显高于鳞癌组(P<0.05)。且靠近肺内带和肺门达12例,明显高于靠近肺外带及胸壁组,差异有统计学意义(P<0.05)。结论经支气管镜肺活检对周围型肺癌患者操作方便安全,可多次施行,治疗效果较理想,是唯一能获得诊断和正确定位的可靠检查方法,可提高对周围型肺癌的诊断率。

Objective To investigate the transbronchial lung biopsy of peripheral lung cancer diagnostic role. Methods From January 2011 to December 2011, the clinical manifestations, X-ray and CT examination of suspected peripheral lung cancer, and the bronchoseopy was not found 50 cases of bronchial sub-segment of the proximal cavity lesions. Passing a fiberoptic bronehoseope （bronehoscopy） lung biopsy （TBLB） surgery. Results The diagnostic transbronehial lung biopsy confirmed 15 cases, the positive rate was 30% （15/50）. Show the different size of the lesion of peripheral lung cancer based on CT, bronchoscopic biopsy positive rate of diagnosis, the difference was significant （P 〈 0.05）. The male patients＇ TBLB positive rate was significantly higher than women, , eight cases adenocarcinoma, four cases of squamous cell carcinoma, two cases of large cell carcinoma, one case of small cell carcinoma, adenocarcinoma was significantly higher than the carcinoma group （P 〈 0.05）. Which close to the lungs and hilar were 12 cases, the TBLB positive biopsy rate was significantly higher than ＂the near pulmonary takeaway and chest group, the difference was significant （P 〈 0.05）. Conclusion Transbronchial lung biopsy operation on patients with peripheral lung cancer is easy and safe, for multiple purposes, is the only way to di- agnose and correct positioning of the reliable inspection methods, can improve the diagnosis of peripheral lung cancer rate.