| Hua Zheng,Baohua Lu,Qunhui Wang,Fanbin Hu,Weimin Ding,Baolan Li. Bronchoscopic biopsy for diagnosis of lung cancer in the absence of visible endobronchial abnormalities. Oncol Transl Med, 2016, 2: 115-118. |
| 气管镜活检对镜下无异常病变肺癌的诊断意义 |
| Bronchoscopic biopsy for diagnosis of lung cancer in the absence of visible endobronchial abnormalities |
| Received:March 01, 2016 Revised:June 14, 2016 |
| DOI：10.1007/s10330-016-0148-6 |
| 中文关键词: 气管镜，肺癌，活检 |
| 英文关键词: bronchoscope; lung cancer; biopsy |
| 基金项目: |
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| 中文摘要: |
| 背景：气管镜检查广泛用于呼吸系统疾病中，特别是恶性肿瘤的诊断。但是，当镜下正常相时，即肉眼未见异常病变时，内镜医师一般不行镜下活检术。
目的：此研究是为评价当气管镜下无异常病变时取活检对肺癌的确诊率及分析其影响因素。
方法：回顾性分析自2008年1月至2012年12月期间入院的109例满足以下条件的患者：病理诊断的肺癌、做了HRCT检查、镜下无任何异常病变但是取了气管镜活检、刷检及灌洗。收集这些患者的临床资料，包括：年龄，性别，病理类型，分期，诊断方式，原发灶位置（中心型、外周型或中间型）、肿瘤大小、纵隔淋巴结转移、以及血清CEA。χ2检验、Fisher精确检验、McNemar检验等用于分析。
结果：在109例中，37例（33.9%）是通过气管镜检查确诊，刷检和灌洗对比活检具有更高的阳性率，P＝0.004。与性别，病理类型、病变位置、肿瘤大小、纵隔淋巴结转移和血清CEA等因素无关，P均大于0.05。
结论：虽然有些肺癌患者镜下为正常相，即没有肉眼可见病变，建议内镜医师行镜下活检，而且这是安全的。结合刷检和灌洗可提高确诊率。 |
| 英文摘要: |
| Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and particularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in case
lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bronchoscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormalities undetectable to the naked eye.
Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The inclusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of
visible endobronchial manifestations, brushing, and bronchoalveolar lavage (BAL) according to the images
obtained from high-resolution computed tomography (HRCT). Data regarding age, sex, pathology, tumor
stage; the method of diagnosis; location of primary lesion (central, peripheral, or intermediate); tumor size,
mediastinal lymph node metastasis, and the serum carcinoembryonic antigen (CEA) value were collected.
The Pearson chi-square test or Fisher’s exact and McNemar tests were used in the univariate analysis.
Results Among the 109 patients, the diagnosis of 37 (33.9%) patients was confirmed through bronchoscopy. Brushing and BAL had higher positive detection rates than biopsy (P = 0.004). There were no differences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node
metastasis, and the serum CEA value (P > 0.05 for all groups).
Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable
by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that
brushing and BAL might increase the positive detection rate of bronchoscopic examination. |
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