经支气管镜钳夹活检技术对支气管壁内恶性病变进行病理取材的诊断价值分析(1)
【摘要】 目的：研究經支气管镜钳夹活检技术对支气管壁内恶性病变进行病理取材的诊断价值。方法：纳入2015年9月-2018年9月本院收治的98例疑似胸部肿瘤患者进行研究，按随机数字表法将其分为两组，各49例。其中49例采用经支气管镜下刷片术检查作为刷片组，另49例采用经支气管镜下肺组织钳夹术检查作为钳夹组。所有患者均以细胞学、组织学病理诊断作为金标准，观察两种技术对支气管壁内恶性病变的诊断效能。结果：刷片组中经金标准检查共有恶性肿瘤患者21例(42.86%)，均为肺癌，其中非小细胞肺癌14例(66.67%)，小细胞肺癌7例(33.33%);良性肿瘤患者28例(57.14%)，其中肺结节16例(57.14%)，肺结核10例(35.71%)，肺纤维化2例(7.14%)。钳夹组中经金标准检查共有恶性肿瘤患者25例(51.02%)，均为肺癌，其中非小细胞肺癌16例(64.00%)，小细胞肺癌9例(36.00%);良性肿瘤患者24例(48.98%)，其中肺结节15例(62.50%)，肺结核8例(33.33%)，肺纤维化1例(4.17%)。刷片组与金标准胸部肿瘤阳性诊断率对比，差异有统计学意义(26.53% vs 42.86%，字2=5.885，P<0.05);钳夹组与金标准胸部肿瘤阳性诊断率对比，差异无统计学意义(40.82% vs 51.02%，字2=2.095，P>0.05)。两组检查方式对胸部肿瘤的诊断特异度和阴性预测值对比，差异均无统计学意义(P>0.05);钳夹组灵敏度、阳性预测值及准确度均明显高于刷片组，差异均有统计学意义(P<0.05)。两组对小细胞肺癌诊断率比较，差异无统计学意义(P>0.05);钳夹组非小细胞肺癌诊断率明显高于刷片组，差异有统计学意义(P<0.05)。结论：经支气管镜钳夹活检技术对支气管壁内恶性病变诊断率较高，诊断效能较好，对胸部恶性肿瘤病理分型的判定具有重要价值，值得临床应用及推广。
【关键词】 支气管镜 钳夹术 刷片术 支气管壁 胸部肿瘤
[Abstract] Objective： To study the diagnostic value of transbronchial lung biopsy forceps in malignant bronchial wall lesions. Method： A total of 98 suspected thoracic tumor patients treated in our hospital from September 2015 to September 2018 were selected. According to the method of random number table， they were divided into two groups， 49 cases in each group. Among them， 49 cases were treated with brush under bronchoscopy (brush group) and the other 49 cases were treated with forceps under bronchoscopy (forceps group). All patients took cytological and histopathological diagnosis as the gold standard to observe the diagnostic efficacy of the two techniques for malignant lesions in the bronchial wall. Result： In brush group， the pathological results indicated there were 21 patients (42.86%) with malignant lung cancer， involved with 14 patients (66.67%) with non-small cell lung cancer and 7 patients (33.33%) with small cell lung cancer cases. 28 patients (57.14%) with benign tumor， involved with 16 patients (57.14%) with pulmonary nodule， 10 patients (35.71%) with pulmonary tuberculosis and 2 patients (7.14%) with pulmonary fibrosis. In forceps group， the pathological results indicated 25 patients (51.02%) with lung cancer， involved with 16 patients (64.00%) with non-small cell lung cancer and 9 patients (36.00%) with small cell lung cancer. 24 patients (48.98%) with benign tumor， involved with 15 patients (62.50%) with pulmonary nodule， 8 patients (33.33%) with pulmonary tuberculosis and 1 patient (4.17%) with pulmonary fibrosis. The positive diagnosis rate of thoracic cancer based on brush technique and golden standard were significantly different (26.53% vs 42.86%， 字2=5.885， P<0.05). The positive diagnosis rate of thoracic cancer based on forceps technique and golden standard showed no statistically significant difference (40.82% vs 51.02%， 字2=2.095， P>0.05). The diagnosis specificity and negative predictive value of two techniques showed no statistically significant difference (P>0.05). The diagnosis sensitivity， positive predictive value and diagnosis accuracy in forceps group were statistically higher than those of brush group (P<0.05). The diagnosis rate of small cell lung cancer of two techniques showed no statistically significant difference (P>0.05). The diagnosis rate of non-small cell lung cancer in forceps group was statistically higher than that of brush group (P<0.05). Conclusion： The transbronchial lung biopsy forceps has higher diagnosis accuracy and efficacy， and plays an important role in the pathological classification of malignant tumor， it is worthy of clinical application and promotion., 百拇医药(张晓琦)
【关键词】 支气管镜 钳夹术 刷片术 支气管壁 胸部肿瘤
[Abstract] Objective： To study the diagnostic value of transbronchial lung biopsy forceps in malignant bronchial wall lesions. Method： A total of 98 suspected thoracic tumor patients treated in our hospital from September 2015 to September 2018 were selected. According to the method of random number table， they were divided into two groups， 49 cases in each group. Among them， 49 cases were treated with brush under bronchoscopy (brush group) and the other 49 cases were treated with forceps under bronchoscopy (forceps group). All patients took cytological and histopathological diagnosis as the gold standard to observe the diagnostic efficacy of the two techniques for malignant lesions in the bronchial wall. Result： In brush group， the pathological results indicated there were 21 patients (42.86%) with malignant lung cancer， involved with 14 patients (66.67%) with non-small cell lung cancer and 7 patients (33.33%) with small cell lung cancer cases. 28 patients (57.14%) with benign tumor， involved with 16 patients (57.14%) with pulmonary nodule， 10 patients (35.71%) with pulmonary tuberculosis and 2 patients (7.14%) with pulmonary fibrosis. In forceps group， the pathological results indicated 25 patients (51.02%) with lung cancer， involved with 16 patients (64.00%) with non-small cell lung cancer and 9 patients (36.00%) with small cell lung cancer. 24 patients (48.98%) with benign tumor， involved with 15 patients (62.50%) with pulmonary nodule， 8 patients (33.33%) with pulmonary tuberculosis and 1 patient (4.17%) with pulmonary fibrosis. The positive diagnosis rate of thoracic cancer based on brush technique and golden standard were significantly different (26.53% vs 42.86%， 字2=5.885， P<0.05). The positive diagnosis rate of thoracic cancer based on forceps technique and golden standard showed no statistically significant difference (40.82% vs 51.02%， 字2=2.095， P>0.05). The diagnosis specificity and negative predictive value of two techniques showed no statistically significant difference (P>0.05). The diagnosis sensitivity， positive predictive value and diagnosis accuracy in forceps group were statistically higher than those of brush group (P<0.05). The diagnosis rate of small cell lung cancer of two techniques showed no statistically significant difference (P>0.05). The diagnosis rate of non-small cell lung cancer in forceps group was statistically higher than that of brush group (P<0.05). Conclusion： The transbronchial lung biopsy forceps has higher diagnosis accuracy and efficacy， and plays an important role in the pathological classification of malignant tumor， it is worthy of clinical application and promotion., 百拇医药(张晓琦)