探讨痰脱落细胞学、纤维支气管镜及CT检查对肺癌的诊断价值

The diagnostic value of sputum cytology, fiberoptic bronchoscope and CT for lung cancer

目的探讨痰脱落细胞学、纤维支气管镜、CT检查及三者联合检查对肺癌的诊断价值。方法对我院收治的363例肺癌患者进行痰脱落细胞学、纤维支气管镜及CT检查，计算这三种方法对不同病变位置（中央型肺癌、周围型肺癌）和不同组织学类型（鳞癌、腺癌、小细胞肺癌）肺癌检测的敏感性及联合诊断的阳性率，并进行统计学分析。结果363例肺癌患者中，痰脱落细胞学和纤维支气管镜检查对中央型肺癌的敏感性均显著高于周围型肺癌，差异均有统计学意义（P均〈0．05），痰脱落细胞学检查对腺癌的敏感性高于鳞癌和小细胞肺癌，差异有统计学意义（P〈0．05），三种方法联合检测阳性率为98．8％，高于单独检测及两两联合检测。结论痰脱落细胞学及纤维支气管镜对中央型肺癌诊断价值较高，三种方法联合检测肺癌诊断的阳性率最高，对于不能耐受纤维支气管镜患者，应多次行痰脱落细胞学检查，并联合CT检查，可提高肺癌诊断阳性率。

Objective To investigate the diagnostic value of sputum cytology, fiberoptic bronchoseopy and CT for lung cancer. Methods 363 cases lung cancer patients were detected by sputum cytology, bronchofibroscope and CT. The detective sensitivity of three methods and positive rates of combined detection in different lesion location （central lung cancer, peripheral lung cancer） and histological type （squamous carcinoma, adenomatous carcinoma and small cell lung cancer） were calculated. And the data were statistical analyzed. Results In 363 lung cancer patients, the detective sensitivity of sputum cytology and fiberoptic hronchofibroscope in central lung cancer were all higher than in peripheral lung cancer, and the differences all had statiscal significance （Pall〈 0.05 ）. The detective sensitivity of sputum cytology in adenomatous carcinoma was higher than in squamous carcinoma and small cell lung cancer, and the difference had statistical sifnificance （P〈 0.05 ）. The positive rates of three methods combined detection was 98.8%, higher than single detection and two methods combined detection. Conclusion There is high diagnostic value of suputum cytology and fiberoptic bronchoscope in central lung cancer,the diagnostic value of three methods combined detection had highest positive rate. To those who can not be tolerate of fiberoptic bronchofibroscope should increased the times of sputum cytology detection, and unite CT to ineresed the positive rate of diagnosis.