纤支镜联合细胞学检测在肺肿瘤诊断中的应用*

Application of fibrobronchoscope combined with cytology in diagnosis of lung tumors*

摘要:

研究纤支镜联合细胞学检测在肺肿瘤诊断中的应用价值。方法?对该院2016年4月－2017年4月收治的80例肺肿瘤患者的临床资料进行统计分析，依据诊断方法将这些患者分为纤支镜活检联合液基细胞学检测组（液基细胞学组，n =40）和纤支镜活检联合传统涂片检测组（传统涂片组，n =40），对两组患者的诊断结果、液基细胞学组与组织病理学类型诊断结果、传统涂片组与组织病理学类型诊断结果进行统计分析。结果?液基细胞学组患者中，恶性肿瘤细胞30例，可疑恶性肿瘤细胞3例，未见恶性细胞7例，诊断的阳性率、阴性率分别为82.50%（33/40）和17.50%（7/40）。传统涂片组患者中，恶性肿瘤细胞13例，可疑恶性肿瘤细胞8例，未见恶性细胞19例，诊断的阳性率、阴性率分别为52.50%（21/40）和47.50%（19/40），液基细胞学组患者的诊断总体阳性率明显高于传统涂片组（P <0.05），恶性肿瘤诊断阳性率明显高于传统涂片组（P <0.01）。液基细胞学组鳞癌、腺癌和小细胞癌的诊断率9.09%（3/33）、12.12%（4/33）和30.30%（10/33）均明显低于组织病理学的30.00%（12/40）、32.50%（13/40）和32.50%（13/40）（P <0.05），非小细胞癌诊断率36.36%（12/33）明显高于组织病理学2.50%（1/40）（P <0.01），类型不确定比例12.12%（4/33）与组织病理学2.50%（1/40）相比，差异无统计学意义（P >0.05）。传统涂片组鳞癌、腺癌和小细胞癌的诊断率9.52%（2/21）、19.05%（4/21）和19.05%（4/21）均明显低于组织病理学的32.50%（13/40）、17.50%（7/40）和45.00%（18/40）（P <0.05），类型不确定比例38.10%（8/21）高于组织病理学2.50%（1/40）（P <0.01），非小细胞癌诊断率14.29%（3/21）与组织病理学2.50%（1/40）比较，差异无统计学意义（P >0.05）。结论?纤支镜活检联合液基细胞学与传统涂片检测在肺肿瘤诊断中比较，有较高的应用价值。

Abstract:

To study the clinical value of fibrobronchoscopy combined with cytology in diagnosis of lung tumors. Methods The clinical data of 80 patients with lung tumors diagnosed and treated from April 2016 to April 2017 were statistically analyzed. According to the diagnostic method, these patients were divided into two groups, the group of fibre bronchoscopy combined with liquid-based cytology (group of liquid-based cells, n = 40) and the group of fibrobronchoscopy combined with traditional smear (group of traditional smear, n = 40). The diagnostic results, diagnostic results of liquid-based cytology and histopathological type, traditional smear group and histopathological type between the two groups were statistically analyzed. Results 30 cases of malignant tumor cells, 3 cases of suspicious tumor cells and 7 cases of no malignant cells were found in the liquid-based cytology group. The positive and negative rates of diagnosis were 82.50% (33/40) and 17.50% (7/40). 13 cases of malignant tumor cells, 8 cases of suspicious tumor cell and 19 cases of no malignant cells were found in traditional smear group. The positive and negative rates of diagnosis were 52.50% (21/40), 47.50% (19/40). The liquid-based cytology group diagnosis in patients with total positive rate was significantly higher than that of traditional smear group (P < 0.05), and the malignant tumor diagnosis positive rate was significantly higher than that of traditional smear group (P < 0.01). The diagnostic rate of squamous cell carcinoma, adenocarcinoma and small cell carcinoma in the liquid-based cell study group was 9.09% (3/33), 12.12% (4/33), 30.30% (10/33), significantly lower than that of tissue biopsy 30.00% (12/40), 32.50% (13/40), 32.50% (13/40) (P < 0.05), and 36.36% (12/33) of non-small cell carcinoma was significantly higher than that of tissue biopsy 2.50% (1/40) (P < 0.01). There was no statistically significant difference between the uncertainty type in liquid-based cells group, 12.12% (4/33) and tissue biopsy uncertainty 2.50% (1/40) (P > 0.05). The diagnostic rate of squamous cell carcinoma, adenocarcinoma and small cell carcinoma in the traditional smear group was 9.52% (2/21), 19.05% (4/21), 19.05% (4/21), significantly lower than that of tissue biopsy 32.50% (13/40), 17.50% (7/40), 45.00% (18/40) (P < 0.05). The uncertainty type in traditional smear group 38.10% (8/21) was higher than tissue biopsy 2.50% (1/40) (P < 0.01). There was no statistically significant difference between the non-small cell carcinoma 14.29% (3/21) and histopathological uncertainty ratio of 2.50% (1/40) (P > 0.05). Conclusion The combination of fibre bronchoscope biopsy and liquid-based cytology has a higher application value in diagnosis of lung tumors than the traditional smear test.