代震波, 周德俊, 胡建章, 李凤玲, 刘鹏. 气管镜下针吸活检在非腔内生长型肺癌诊断中的应用—附124例病例报告[J]. 中国肿瘤临床, 2012, 39(17): 1285-1287. DOI: 10.3969/j.issn.1000-8179.2012.17.005
引用本文: 代震波, 周德俊, 胡建章, 李凤玲, 刘鹏. 气管镜下针吸活检在非腔内生长型肺癌诊断中的应用—附124例病例报告[J]. 中国肿瘤临床, 2012, 39(17): 1285-1287. DOI: 10.3969/j.issn.1000-8179.2012.17.005
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Zhenbo DAI, Dejun ZHOU, Jianzhang HU, Fengling LI, Peng LIU. Transbronchial Needle Aspiration Application in Etio-Diagnosis of Cavity Lung Tumor-A Study of 124 Cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(17): 1285-1287. DOI: 10.3969/j.issn.1000-8179.2012.17.005
Citation: Zhenbo DAI, Dejun ZHOU, Jianzhang HU, Fengling LI, Peng LIU. Transbronchial Needle Aspiration Application in Etio-Diagnosis of Cavity Lung Tumor-A Study of 124 Cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(17): 1285-1287. DOI: 10.3969/j.issn.1000-8179.2012.17.005
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气管镜下针吸活检在非腔内生长型肺癌诊断中的应用—附124例病例报告

Transbronchial Needle Aspiration Application in Etio-Diagnosis of Cavity Lung Tumor-A Study of 124 Cases

    摘要
  • 摘要:
      目的   探讨气管镜下针吸活检在非腔内生长型肺癌诊断中的应用，并对影响因素进行回归分析。
      方法   对叶、段支气管非腔内生长型肺癌患者124例进行气管镜针吸活检（transbronchial needle aspiration，TBNA）。分为2组：A组为表面黏膜正常，B组表面黏膜明显充血、颗粒样粗糙。其中A组进行TBNA+刷片；B组采用TBNA+钳检+刷片。所获标本进行病理学诊断。采用Logistic回归分析进行统计分析。结合CT检查提示有纵隔及肺门淋巴结肿大的86例患者进行淋巴结穿刺活检，初步进行术前N分期。
      结果   124例肺癌患者中A组76例、B组48例。全部患者的TBNA及刷片诊断阳性率分别为75.80%和30.64%，TBNA明显高于刷片（χ2=50.79，P < 0.001）。A组中，TBNA诊断阳性率明显高于刷片诊断阳性率（78.94% vs. 18.42%，P < 0.001）。B组病例中，TBNA、钳检及刷片诊断阳性率分别为70.83%（34/48）、25.00%（12/48）、50.00%（24/48），TBNA阳性率最高（P < 0.001）。86例纵隔及肺门淋巴结肿大的肺癌患者淋巴结穿刺活检，穿刺成功率达73.6%，穿刺阳性率达71.70%。初步分期为N1、N2、N3期的病例分别为8例、44例和12例。Logistic回归分析显示病变部位、大小、病理类型以及穿刺针数是TBNA的主要影响因素。
      结论   TBNA可提高非腔内生长型肺癌及纵隔或肺门淋巴结的病理学诊断率。对肺癌术前明确N分期有明显的帮助，有利于合理选择治疗方式。

     

    Abstract:
      Objective   To discusse the transbronchial needle aspiration (TBNA) application in etio-diagnose cavity lung tumor appearance and N staging.
      Methods   Out of 124 lung cancer patients who underwent TBNA, 86 patients with mediastinal and/or hilar lymph node lesions underwent TBNA for lymph node. All patients were divided into two groups: Group A (normal mucosal changes) and Group B (suspected mucosal changes). Biopsy, TBNA, and brushing were performed. Logistic regression analyses were adjusted for endobronchial visibility, the number of puncture for each position, distance from carina, and tumor size.
      Results   TBNA had 75.80% positive diagnostic rate, which is better than that for bronchial brushing and clamp biopsies. (P < 0.001) In 86 patients with mediastinal and/or hilar lymph node lesions in the CT scan of chest, TBNA for the lymph node has a 73.60% successful rate and the positive rate is 71.70%.The positive rate of TBNA is related to pathological types, the number of puncture for each position, distance from carina, and tumor size.
      Conclusion   TBNA is quite helpful diagnosing and staging an etio-diagnosis of cavity lung tumor.

     

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