电子支气管镜联合快速现场评价对管腔浸润型和外压型肺癌的诊断价值*

Diagnosis value of electronic bronchoscopy combined with ROSE in bronchial infiltrative type and compressive type lung cancer*

摘要:

摘要： 目的??目前较多研究中发现，电子支气管镜对浸润型和外压型肺癌活检诊断率普遍在70.0%左右。该研究旨在探讨电子支气管镜联合快速现场评价（ROSE）对提高浸润型和外压型肺癌诊断率的影响及临床应用价值。方法?回顾性分析2016年1月-2018年1月在十堰市太和医院（湖北医药学院附属医院）接受电子支气管镜检查并最终经一种或多种方法确诊为肺癌的265例患者临床资料，265例肺癌患者在电子支气管镜下仅表现为浸润型或外压型，其中联合ROSE的患者131例，未行ROSE的患者134例。比较两组的活检阳性率、病理诊断费用，并分析ROSE与最终病理结果的一致性。结果?对于浸润型和外压型肺癌，ROSE组与非ROSE组相比，活检阳性率差异有统计学意义（97.1% vs 67.0%，P?<0.05；89.3% vs 56.0%，P?<0.05）；病理诊断费用，ROSE组明显低于非ROSE组（t?=6.02，P?<0.05）。ROSE对鳞癌、腺癌、小细胞癌的诊断与病理结果符合率分别为89.3%、92.3%和99.2%。结论?电子支气管镜联合ROSE有助于提高对浸润型和外压型肺癌的诊断率，降低肺癌患者的病理诊断费用，ROSE对现场活检标本可做出快速诊断并对肺癌进行分型，尤其是对小细胞肺癌的诊断与病理结果符合率可达到99.2%。电子支气管镜联合ROSE对于浸润型和外压型肺癌患者的活检具有一定应用价值。

Abstract:

Abstract: Objective?To investigate the diagnostic and application value of electronic bronchoscope combined with rapid on site evaluation (ROSE) for the diagnosis of different bronchial infiltrative and compressive type lung cancer.?Methods?A retrospective analysis was performed from January 2016 to January 2018 with 265 patients finally diagnosed lung cancer. These lung cancer patients are only bronchial infiltrating and compressive type lung cancer seen under electronic bronchoscope. The patients were divided into two groups, 131 patients were in ROSE group and 134 patients in non-ROSE group. The diagnostic rates and pathological diagnostic costs of these two groups were compared, and the consistency between ROSE and the final pathological results were analyzed.?Results?There was a statistically significant difference in diagnosis rate between ROSE and non-ROSE groups for bronchial infiltrating type cancer (97.1% vs 66.9%, P?