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目的通过纤维支气管镜刷片细胞学及组织活检病理学检查,探讨其对肺癌的诊断价值和组织学分型。方法205例肺癌及94例肺良性疾病病例,经纤维支气管镜同时进行刷片细胞学及组织活检病理学检查。结果纤维支气管镜刷片细胞学诊断肺癌灵敏度、特异度、符合率分别为81.0%、97.9%、86.3%;纤维支气管镜活检病理学诊断肺癌灵敏度、特异度、符合率分别为85.9%、100%、90.3%,与细胞学比较差异无统计学意义(P>0.05);两者联合诊断灵敏度、符合率为95.1%、96.0%,与单检诊断比较差异有统计学意义(P<0.05),而特异度仍有97.9%。细胞学组织分型符合率依次为鳞癌97.3%,未分化癌96.7%,腺癌82.4%。结论纤维支气管镜刷片细胞学检查是一种诊断肺癌的可靠方法,对组织分型亦有较高的参考价值,如与组织活检病理学联检可明显提高术前肺癌诊断的灵敏度。
Objective To investigate the diagnostic value and histological classification of lung cancer by means of cytology and biopsy pathology of bronchoscope. Methods Totally 205 cases of lung cancer and 94 cases of pulmonary benign disease were examined with biopsy and cytology. Results The sensitivities and specificities of lung cancer were 81.0%, 97.9% and 86.3%, respectively. The sensitivity and specificity of fiberoptic bronchoscopy biopsy in diagnosing lung cancer were 85.9% and 100% respectively, , 90.3% respectively. There was no significant difference between the two methods (P> 0.05). The diagnostic sensitivity of the two methods was 95.1% and 96.0%, respectively, which was significantly different from the single diagnosis (P <0.05) The specificity is still 97.9%. The coincidence rates of cytology and tissue typing were as follows: squamous cell carcinoma 97.3%, undifferentiated carcinoma 96.7% and adenocarcinoma 82.4%. Conclusion Cytological examination of bronchofbronchial brush cells is a reliable method to diagnose lung cancer. It also has high reference value for tissue typing. For example, joint biopsy and pathology can obviously improve the sensitivity of preoperative diagnosis of lung cancer.