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目的探讨经纤维支气管镜针刺吸引(TBNA)对肺癌的诊断价值。方法对90例CT检查显示胸内肿块和(或)纵隔-肺门淋巴结肿大的肺癌患者进行TBNA。结果90例肺癌患者中TBNA诊断总阳性率为61.11%(55/90),67例通过纤维支气管镜诊断为肺癌的患者中,45例仅依靠TBNA涂片诊断,其中34例患者TBNA涂片为诊断的唯一病理学依据。90例肺癌患者中,35例TBNA联合其他纤维支气管镜检查患者的阳性率高于55例单行TBNA检查的患者(77.14%vs65.45%,P>0.05)。TBNA联合其他纤维支气管镜检查毛刷阳性率显著高于单行TBNA(45.71%vs22.00%,P<0.05),冲洗阳性率也显著高于TBNA(21.21%vs2.70%,P<0.05)。TBNA诊断小细胞肺癌阳性率高于非小细胞肺癌(92.31%vs62.50%,P>0.05)。TBNA阳性率与穿刺部位无明显相关(P>0.05),淋巴结>3 cm的TBNA阳性率显著高于<3 cm的淋巴结(75.00%vs36.36%,P<0.05)。TBNA主要并发症为穿刺点少许出血。结论TBNA是诊断肺癌安全和有效的方法。
Objective To investigate the diagnostic value of bronchoscopic needle aspiration (TBNA) for lung cancer. Methods TBNA was performed in 90 patients with lung cancer who had thoracic masses and / or mediastinal - hilar lymphadenopathy on CT examination. Results The total positive rate of TBNA in 90 patients with lung cancer was 61.11% (55/90). Of the 67 patients with lung cancer diagnosed by fiberoptic bronchoscopy, 45 patients were diagnosed by TBNA smear only, and TBNA smears in 34 patients were The only pathological basis for diagnosis. Among 90 patients with lung cancer, the positive rate of 35 patients with TBNA combined with other fiberoptic bronchoscopy was higher than that of 55 patients with single lung cancer (77.14% vs 65.45%, P> 0.05). The positive rate of TBNA combined with other fiberoptic bronchoscopy was significantly higher than that of single line TBNA (45.71% vs22.00%, P <0.05). The positive rate of washing was also significantly higher than that of TBNA (21.21% vs2.70%, P <0.05). The positive rate of TBNA in diagnosing small cell lung cancer was higher than that in non-small cell lung cancer (92.31% vs62.50%, P> 0.05). The positive rate of TBNA was not significantly correlated with the puncture site (P> 0.05). The positive rate of TBNA with lymph node> 3 cm was significantly higher than that with lymph node <3 cm (75.00% vs 36.36%, P <0.05). The main complication of TBNA is a little bleeding at the puncture point. Conclusion TBNA is a safe and effective method for the diagnosis of lung cancer.