CAJ | 학술논문

目的研究经支气管活检(TBB)与经支气管针吸活检(TBNA)两种方法对中央型肺癌的诊断价值.方法 2011年1月至2012年10月在我院行手术治疗的中央型肺癌患者150例,就诊后均先行TBNA、再行TBB.回顾性分析两种方法的诊断结果.结果 150例中央型肺癌患者中腔内肿块型33例,TBB确诊33例(100％),TBNA确诊32例(97.0％),差异无统计学意义(P=0.90)；单纯管腔狭窄型26例,TBB确诊1例(3.9％),TBNA确诊26例(100％),差异有统计学意义(P=0.01)；管腔外压型16例,TBB确诊2例(12.5％),TBNA确诊16例(100％),差异有统计学意义(P=0.02)；管腔狭窄合并黏膜弥漫病变型47例,TBB确诊25例(53.2％),TBNA确诊40例(85.1％),差异有统计学意义(P=0.04)；混合型28例,TBB确诊27例(96.4％),TBNA确诊28例(100％),差异无统计学意义(P=0.87).结论针对中央型肺癌不同的气管镜下表现,准确合理选择活检方法可以在保证诊断阳性率的前提下最大限度地降低检查费用,达到最佳效价比.
목적 연구경지기관활검(TBB)여경지기관침흡활검(TBNA)량충방법대중앙형폐암적진단개치.방법 2011년1월지2012년10월재아원행수술치료적중앙형폐암환자150례,취진후균선행TBNA、재행TBB.회고성분석량충방법적진단결과.결과 150례중앙형폐암환자중강내종괴형33례,TBB학진33례(100％),TBNA학진32례(97.0％),차이무통계학의의(P=0.90)；단순관강협착형26례,TBB학진1례(3.9％),TBNA학진26례(100％),차이유통계학의의(P=0.01)；관강외압형16례,TBB학진2례(12.5％),TBNA학진16례(100％),차이유통계학의의(P=0.02)；관강협착합병점막미만병변형47례,TBB학진25례(53.2％),TBNA학진40례(85.1％),차이유통계학의의(P=0.04)；혼합형28례,TBB학진27례(96.4％),TBNA학진28례(100％),차이무통계학의의(P=0.87).결론 침대중앙형폐암불동적기관경하표현,준학합리선택활검방법가이재보증진단양성솔적전제하최대한도지강저검사비용,체도최가효개비.
Objective To investigate the diagnostic value of transbronchial needle aspiration (TBNA) and transbronchial biopsy(TBB) in central lung cancer.Methods Retrospectively analyzed the diagnostic data of 150 patients with central lung cancer who underwent TBNA followed by TBB in our hospital from January 2011 to October 2012.Results Among 150 patients with central lung cancer,33 cases had intracavity mass.Thirtythree cases (100％) were confirmed by TBB and 32 cases (97.0％) confirmed by TBNA.There was no statistically significant difference between the diagnosis of TBB and TBNA(P =0.90).There were 26 cases with simple stenosis,among which 1 case(3.9％) confirmed by TBB and 26 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.01) Sixteen cases belonged to the lumen external pressure type with 2 cases(12.5％) were confirmed by TBB and 16 cases(100％) confirmed by TBNA.And there was statistically significant difference was observed between the diagnosis by TBB and TBNA (P =0.02).Forty-seven cases had luminal stenosis combined with mucosal diffuse lesions with 25 cases(53.2％) confirmed by TBB and 40 cases(85.1％) confirmed by TBNA.And there was statistical difference was observed between the diagnosis of TBB and TBNA(P =0.04).Twenty-eight cases had mixed type central lung cancer with 27 cases(96.4％) confirmed by TBB and 28 cases(100％) confirmed by TBNA.No statistically significant difference was observed between the diagnosis of TBB and TBNA (P =0.87).Conclusion According to endoscopic performance of central lung cancer,accurate and reasonable choice of biopsy method can minimize inspection costs on the basis of maintaining positive rate of diagnosis in order to achieve optimal titer.