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目的探讨肺癌纤维支气管镜镜下特点及其与病理学结果的关系。方法回顾分析2008年4月至2011年4月收治的经纤维支气管镜确诊363例肺癌患者的临床资料及纤维支气管镜下表现。结果鳞癌174例(47.93%),发病年龄(62.20±9.68)岁,其中8例为低分化,2例为中-低分化;小细胞癌90例(24.79%),发病年龄(58.33±9.63)岁;腺癌84例(23.14%),发病年龄(58.05±12.28)岁,13例为低分化;黏液表皮样癌3例(0.83%);腺鳞癌2例(0.55%);梭形细胞癌和类癌各1例(0.27%);病理类型不确定8例(2.20%)。病灶镜下多表现为新生物、黏膜肥厚、黏膜结节样隆起。鳞癌以增生性改变为主,占60.34%;腺癌以浸润性改变为主,占83.33%;小细胞癌也以浸润性改变多见,占67.78%。60岁为男性患者肺癌高发的年龄;363例中男:女=2.21:1;男性肺癌中鳞癌的构成比高于女性(P<0.01),女性肺癌中,腺癌构成比高于男性(P<0.01)。结论鳞癌为肺癌最常见类型,纤维支气管镜镜下表现多为直接征象,镜下表现与组织学分类存在一定关系,了解上述特点,可通过镜下表现推测肺癌的可能病理类型。
Objective To investigate the characteristics of lung cancer bronchoscopy and its relationship with pathological findings. Methods The clinical data and bronchoscopic findings of 363 lung cancer patients diagnosed by bronchofibroscopy from April 2008 to April 2011 were retrospectively analyzed. Results Squamous cell carcinoma (174 cases) (47.93%) had an age of onset of (62.20 ± 9.68) years, of which 8 cases were poorly differentiated and 2 cases moderately to poorly differentiated. Small cell carcinoma was found in 90 cases (24.79%), ); Adenocarcinoma in 84 cases (23.14%), the age of onset (58.05 ± 12.28) years, 13 cases of poorly differentiated; mucoepidermoid carcinoma in 3 cases (0.83%); adenosquamous carcinoma in 2 cases (0.55% 1 case (0.27%) in each of cell carcinoma and carcinoid, and 8 cases (2.20%) of unknown pathological type. Microscopic lesions showed more new organisms, mucosal hypertrophy, mucosal nodules uplift. Squamous cell carcinoma was mainly hyperplastic, accounting for 60.34%. Adenocarcinoma was mainly infiltrative, accounting for 83.33%. Small cell carcinoma was more common in invasive changes, accounting for 67.78%. The age of 60-year-old male patients with high incidence of lung cancer; 363 cases of male: female = 2.21: 1; male lung cancer squamous cell carcinoma than the female (P <0.01), female lung cancer, adenocarcinoma than male P <0.01). Conclusions Squamous cell carcinoma is the most common type of lung cancer. Fiberoptic bronchoscopy is mostly a direct manifestation. There is a relationship between microscopic findings and histological classification. To understand the above characteristics, the possible pathological types of lung cancer can be speculated through microscopic findings.