摘要
目的探讨纤维支气管镜下黏膜及肺活检、CT引导下经皮肺活检、痰液病理细胞学检查对不明原因肺部肿块的诊断价值。方法回顾性分析不明原因肺部肿块住院病人101例。结果101例患者中行纤支镜检查73例,CT引导下经皮肺活检18例,其中10例完成上述两种检查,纤支镜与经皮肺活检诊断符合率70%。经病理学明确恶性肿瘤诊断54例。中央型肿块纤支镜检灵敏度为88%(21/24),特异度为100%(3/3);周围型肿块纤支镜检灵敏度为43%(10/23),特异度为100%(21/21);CT引导下经皮肺活检灵敏度及特异度分别为80%(8/10)和100%(8/8)。经皮肺活检并发症发生率为22%,高于纤支镜检的12%,且有严重并发症产生。30%患者行痰液病理细胞学检查,阳性率6%。结论痰液的病理细胞学检查简便易行且费用低廉,但阳性率偏低。中央型肿块首选纤支镜下黏膜及肺活检。周围型肿块应根据肿块部位及大小决定先行纤支镜检查还是先行经皮肺活检。
Objective To explore the diagnostic value of transbronchial lung biopsy(TBLB), CT-guided percutaneous lung biopsy and sputum cytology for unknown lung mass. Methods The clinical data of 101 inpatients with unknown lung mass were retrospectively analyzed. Results Among the 101 cases, 73 cases underwent fibrous bronchoscopic examination, 18 cases underwent CT-guided percutaneous lung biopsy, and 10 cases underwent both of them.The diagnostic coincident rate of the two methods was 70%. 54 cases were diagnosed lung carcinoma by pathology. The sensitivity and specificity of TBLB for diagnosing central type of tumor were 88% and 100%, respectiely, and those for diagnosing peripheral type of tumor were 43% and 100%, respectively. The sensitivity of CT-guided percutaneous lung biopsy was 80%,while the specificity was 100%. Complication frequency in the CT-guided percutaneous lung biopsy was 22%, and much higher than that (12%) in the TBLB. Only 30% cases underwent sputum cytology examination, and the positive rat was 6%. Conclusion Sputum cytologic examination is a convenient and cheap method, but its diagnostic rate is relatively low. TBLB was the first choice for examining central type of lung mass. For the peripheral type of lung mass, examination method was selected based on the location and size of the mass.
出处
《中国医师杂志》
CAS
2005年第5期612-614,共3页
Journal of Chinese Physician
