支气管壁增厚在中央型肺癌诊断与鉴别诊断中的价值

Evaluation of Bronchial Wall Thickening in Diagnosis and Differentiation of Central Pulmonary Cancer

目的 评价支气管壁厚度在中央型肺癌诊断与鉴别诊断中的价值。资料与方法 对照分析 5 7例中央型肺癌、2 8例支气管内膜结核及 10例支气管腔内肿瘤的支气管壁厚度 ,测量支气管壁厚度 (T)及管壁增厚长度(L) ,计算出T/L比值。结果 5 7例中央型肺癌能够显示支气管壁增厚 4 5例 (占 78.9% ) ,T/L为 0 .6 4。 2 8例支气管内膜结核表现支气管壁增厚 6例 (占 2 1.4 % ) ,T/L为 0 .2 2。 5 7例中央型肺癌与 2 8例支气管内膜结核支气管壁增厚检出率有非常显著性统计学差异 (P <0 .0 1)。 4 5例中央型肺癌与 6例支气管内膜结核支气壁厚度统计学有显著性差异 (P <0 .0 5 ) ,L及T/L有非常显著性差异 (P <0 .0 1)。 4例支气管腔内恶性肿瘤表现腔内结节伴有支气管壁增厚 ,5例支气管腔内良性肿瘤及 1例支气管转移瘤表现支气管腔内结节不伴支气管壁的增厚。结论 支气管壁增厚是诊断中央型肺癌和鉴别支气管腔内良恶性肿瘤的依据。

Objective To evaluate 'bronchial wall thickening' sign in the diagnosis and differentiation of central lung cancer.Materials and Methods Bronchial wall thickness (T) and the length of the thickened bronchial wall (L) in 57 patients with central pulmonary cancer, in 28 patients with endobronchial tuberculosis and in 10 patients with intrabronchial tumor were measured, T/L ratios were calculated, and the results were compared between each other.Results Of 57 patients with central pulmonary cancer, thickened bronchial wall was seen in 45 (79%) with T/L ratio of 0.64. In 28 cases with endobronchial tuberculosis, thickened bronchial wall was seen in 6 (21.4%) with T/L ratio of 0.22. Significant difference in the detecting rate of thickened bronchial wall existed between central pulmonary cancer group and endobronchial tuberculosis group (P<0.01). Marked difference in bronchial wall thickness was also found between 45 patients of lung cancer and 6 patients of endobronchial tuberculosis, who showed 'bronchial wall thickening' sign (P<0.05), with significant difference in L value and T/L ratio (P<0.01). Of 10 patients with intrabronchial tumor, malignancy was seen in 4, presenting as endobronchial nodule and thickened bronchial wall. Benign tumor was seen in 5 and bronchial metastasis in one, displaying as intrabronchial nodule without wall thickening.Conclusion Bronchial wall thickening is an important sign for the diagnosis of central pulmonary cancer and for the differentiation of benign with malignant endobronchial tumors. T/L ratio is of help in the differentiation of central pulmonary cancer.