气管镜窄带成像技术在支气管肺癌临床诊断中的应用

Application of bronchoscopy narrowband imaging technique in the clinical diagnosis of bronchogenic carcinoma

目的探讨气管镜窄带成像技术在支气管肺癌患者诊断中的临床应用。方法回顾性选取九江市第三人民医院呼吸内科2020年1月至2021年2月收治的疑似合并气道不完全阻塞中央型肺癌患者110例作为研究对象,所有患者均使用支气管光镜检查及窄带成像分析,以病理活检为金标准,比较两者对支气管肺癌的诊断效能。结果110例疑似肺癌患者中,经病理活检后确诊87例中央型肺癌,窄带成像技术的敏感度为91.95%、特异度为86.96%、准确率为90.91%、阳性预测值为96.39%、阴性预测值为74.07%,Kappa值为0.742,与金标准一致性较好。87例肺癌患者窄带成像检查中血管条索状扭曲28例,以鳞癌(21.84%)为主;血管点状分布27例,以腺癌(20.69%)为主;血管突然中断32例,以鳞癌(22.99%)为主。结论气管镜窄带成像内镜在支气管肺癌检查中具有良好的检查效率,与光镜检查相比具备更高的敏感度与特异度,可有效定位病变区域并对其组织血管情况进行检查,提高临床诊断效率。

Objective To explore the clinical application of bronchoscopy narrowband imaging technique in the diagnosis of patients with bronchogenic carcinoma.Methods A total of 110 patients with suspected central lung cancer complicated with incomplete airway obstruction admitted to the Department of Respiratory Medicine,Third People′s Hospital of Jiujiang City were retrospectively selected as the research subjects between January 2020 and February 2021.All patients were examined by bronchoscopy and narrowband imaging analysis,and biopsy was taken as the gold standard to compare the diagnostic efficacy of the two examination methods on bronchogenic carcinoma.Results Among 110 suspected lung cancer patients,87 cases of central lung cancer were diagnosed by pathological biopsy.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value of narrowband imaging were 91.95%,86.96%,90.91%,96.39%,74.07%,and 0.742,which were in good consistency with the gold standard.Among 87 cases of patients with lung cancer,narrowband imaging showed there were 28 cases of vascular cord distortion(mainly squamous cell carcinoma[21.84%]),27 cases of vascular punctate distribution(mainly adenocarcinoma[20.69%])and 32 cases of sudden vascular interruption(mainly squamous cell carcinoma[22.99%]).Conclusion Bronchoscopy narrowband imaging endoscopy has a good inspection efficiency in the examination of bronchogenic carcinoma.Compared with light microscopy,it has higher sensitivity and specificity,and can effectively locate the diseased area and examine its tissue and blood vessels to improve the clinical diagnostic efficiency.