经支气管镜确诊CT隐性肺癌

Analysis of CT-occult lung cancer diagnosed by bronchoscopy

目的 探讨CT隐性肺癌的临床病理特征和支气管镜检特征.方法 回顾性分析11例胸部平扫CT检查未见异常,但经支气管镜检查确诊肺癌患者的临床资料、病变部位和支气管镜检特征.结果 11例CT隐性肺癌患者中,表现为咯血或痰血7例,中位病程为3个月.9例患者临床分期为Ⅰ期、Ⅱ期,其中5例接受手术治疗,5年生存率达80.0％;病变部位涉及两肺各支气管分支,且好发于双上肺;病理类型以鳞癌为主,鳞癌支气管镜下表现均为增生性改变.结论 反复咯血或痰血的患者胸部平扫CT未见异常,也应及时行支气管镜检以明确有无CT隐性肺癌的可能.

Objective To explore the clinicopathological and bronchoscopic characteristics of CT-occult lung cancer.Methods Clinical data of 11 patients who were diagnosed with CT-occult lung cancer by bronchoscopy were analyzed retrospectively.Results Seven out of eleven patients had bloody sputum.The median disease course was 3 months.Nine patients were in stage Ⅰ or Ⅱ,among them 5 cases underwent surgery,with a 5-year survival rate of 80.0％.The upper lobes were predilection areas,and all of the 11 patients had direct sign by bronchoscopy.The most common histopathology was squamous cell carcinoma,which had proliferative changes.Conclusions Patients with symptoms of persistent bloody sputum should undergo a bronchoscopy to make sure whether there is an occult lung cancer or not,even if the chest CT scan is negative at first visit.