支气管镜下活检并刷检结合经支气管针吸活检在肺癌诊断中的临床应用价值.pdfVIP

610 临床肺科杂志　 2015年4 月　 第20卷第4期 支气管镜下活检并刷检结合经支气管针吸 活检在肺癌诊断中的临床应用价值 1 1 2 1 1 姚汉清　 许文景 　 秦艳 　 徐兴祥 　 王正东 【摘要】　 目的　 探讨支气管镜下活检并刷检结合经支气管针吸活检对肺癌的诊断作用。 方法　 在491 例支气管镜检查中常规行支气管镜下病变活检并刷检,其中胸部增强 CT检查提示纵隔和/ 或肺门淋巴结肿 大同时伴有或不伴有肺部病变的37例患者,对其纵隔和/ 或肺门肿大淋巴结予以经支气管针吸活检 (trans- bronchial needle aspiration,TBNA)。 对所有获取的标本进行细胞学或病理学检查。 结果　 491例患者中,269 例(54．8%)获得明确的病理诊断,其中37例TBNA患者的穿刺成功率和病理诊断阳性率分别为81．1%(30/ 37)和70．3%(26/ 37),从而提高了支气管镜检查对肺癌诊断的阳性率。 所有受检患者均无明显的并发症。 结论　 常规支气管镜检查中对病变进行活检并刷检结合TBNA操作简便、安全且有效,对临床肺癌患者的病 理诊断率高。 【关键词】　 经支气管针吸活检;支气管镜检查;肺癌;淋巴结 Diagnostic value of bronchoscopic clamp biopsies and bronchial brushing combined with transbronchial nee- dle aspiration in patients with suspected lung cancer　 YAOHan-qing,XU Wen-jing,QIN Yan,XUXing-xiang, WANGZheng-dong　 RespiratoryDepartment,NorthernJiangsuPeople′sHospital,Yangzhou,Jiangsu　 225001,Chi- na 【Abstract】　 Objective　 To investigate the diagnostic value of clamp biopsies and bronchial brushing com- binedwithtransbronchialneedleaspiration (TBNA)inpatientswithsuspectedlungcancer. Methods　 Thestandard bronchoscopic procedures including clamp biopsies and bronchial brushing were performed in491 patients with lung lesions,and TBNA were usedfor mediastinal and/ or hilar enlargedlymph nodesin enhanced CT scan of chestwith/ without lung lesions atthesametime. ThesamplesofTBNAformediastinaland/ orhilarlymphnodes,transbronchial brushing and clamp biopsieswere examined pathologically or cytologically. Results　 In491cases,thetotal positive diagnostic rate of endoscopy was 54.8%,and the success rate and positive diagnostic rate of TBNA were 81．1% (30/ 37) and70．3% (26/ 37) in37 cases,respectively． S