CAJ | 학술논문

目的：评价纤维支气管镜(纤支镜)下不同取材方法对肺癌诊断的价值，探讨纤支镜下联合采用多种取材方法对肺癌诊断的临床意义。方法分析130例肺癌患者的纤支镜检查结果，比较钳检、刷检、经纤支镜肺活检( TBLB)、单纯经纤支镜针吸活检( TBNA)、支气管肺泡灌洗( BAL)及联合取材方法诊断肺癌的阳性率。结果130例肺癌经纤支镜确诊122例，镜下分为六型：中央增生型、中央浸润型、中央外压型、中央正常型、周围增生浸润型、周围外压正常型；钳检、刷检、TBLB、TBNA、BAL的阳性率分别为83．33%、56．92%、50．00%、67．35%、42．31%，钳检阳性率明显高于另4种单一方法取材( P<0．05)；不同镜下类型分别采用刷检联合其他4种方法检查的总阳性率为93．85%(122/130)，平均阳性率为89．99%；不同取材方法对不同镜下类型肺癌的检出不同。结论根据镜下特点的不同采取不同经纤支镜取材方法、重视钳检、积极开展TBLB、TBNA、联合多种取材方法可提高肺癌的病理学诊断率。
목적：평개섬유지기관경(섬지경)하불동취재방법대폐암진단적개치，탐토섬지경하연합채용다충취재방법대폐암진단적림상의의。방법분석130례폐암환자적섬지경검사결과，비교겸검、쇄검、경섬지경폐활검( TBLB)、단순경섬지경침흡활검( TBNA)、지기관폐포관세( BAL)급연합취재방법진단폐암적양성솔。결과130례폐암경섬지경학진122례，경하분위륙형：중앙증생형、중앙침윤형、중앙외압형、중앙정상형、주위증생침윤형、주위외압정상형；겸검、쇄검、TBLB、TBNA、BAL적양성솔분별위83．33%、56．92%、50．00%、67．35%、42．31%，겸검양성솔명현고우령4충단일방법취재( P<0．05)；불동경하류형분별채용쇄검연합기타4충방법검사적총양성솔위93．85%(122/130)，평균양성솔위89．99%；불동취재방법대불동경하류형폐암적검출불동。결론근거경하특점적불동채취불동경섬지경취재방법、중시겸검、적겁개전TBLB、TBNA、연합다충취재방법가제고폐암적병이학진단솔。
Objective To evaluate the diagnostic value of different sampling under fibrobronchoscope for lung cancer. Methods The fibreoptic bronchoscopy results of 130patients with lung cancer were retrospectively ana-lyzed. The diagnostic positive rate was compared among clamp biopsy, brush biopsy, transbronchial lung biopsy ( TBLB) , transbronchial needle aspiration biopsy ( TBNA) , bronchoalveolar lavage ( BAL) and the combined bron-chofibroscopic biopsy. Results The manifestation in 130 final diagnosed lung cancer patients with fibrobronchoscope could be classified as proliferation, infiltration, suppression and normal forms. The positive rate of clamp biopsy, brush biopsy, TBLB, TBNA and BAL was 83. 33%, 56. 92%, 50. 00%, 67. 35% and 42. 31% respectively, which of clamp biopsy were the highest (P<0. 05). The total positive rate in different lesion with brush biopsy combining other four methods was 93. 85% (122/130), and the average positive rate was 89. 99%. The positive rate was dif-ferent while using different drawing materials method through fibrobronchoscope for different types of lung cancer. Conclusion According to the different type of lung cancer to get specimen at different way, the combined sampling can improve the positive diagnostic rate of lung cancer via fibrobronchoscope.