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本文对自1978年9月至1986年3月采用OlympusBF-B_2型纤维支气管镜对肺部可疑病变进行检查的,1,300例中取材经病理及细胞学证实为肺癌604例进行了分析,并对纤维支气管镜在肺癌诊断中的价值进行了讨论。年龄最小者26岁,最大者72岁。604例中鳞癌占65.07％。未分化癌占13.41％,腺癌占13.41％,其它占8.11％。位于气管11例,主支气管112例,上叶(包括段支气管)324例,下叶88例,右肺中叶69例。镜下所见病灶为增生型者431例,浸润型171例,外压征2例。本文将镜检诊断与影像诊断进行了比较,凡影像表现肺门肺野块影伴肺不张阻塞性炎症者140例,镜下诊断为肺癌者136例,确诊率达97.14％,而单纯肺野块影201例,镜下诊断为肺癌者164例,诊断率为81.59％,肺野块影及肺门增大者149例,镜下诊断为肺癌者142例,诊断率达95.3％,肺门块影114例,镜下诊断为肺癌者107例,诊断率达93.86％。讨论中提出了纤支镜诊断肺癌的作用及价值,以及镜下正确取材的重要性和镜捡后对尚未确诊的病例继续查痰的必要性。
In this article, from September 1978 to March 1986, Olympus BF-B_2 fiberoptic bronchoscopes were used to examine lung suspicious lesions. Among 1,300 patients with lung cancer, 604 patients with lung cancer confirmed by pathology and cytology were analyzed. The value of bronchoscopy in the diagnosis of lung cancer is discussed. The youngest 26 years old, the largest 72 years old. 604 cases of squamous cell carcinoma accounted for 65.07%. Undifferentiated cancers accounted for 13.41%, adenocarcinomas 13.41%, and others 8.11%. In the trachea in 11 cases, the main bronchus 112 cases, the upper lobe (including segmental bronchus) 324 cases, 88 cases of the lower lobe, 69 cases of right middle lobe. The lesions seen under the microscope were 431 cases of hyperplasia, 171 cases of infiltration, and 2 cases of external pressure. This article compared the microscopic examination diagnosis with the imaging diagnosis. All the images showed 140 cases of hilar obstructive inflammation with pulmonary atelectasis, 136 cases were diagnosed as lung cancer by endoscopy, and the diagnosis rate was 97.14%. There were 201 cases of wild patches, 164 cases were diagnosed as lung cancer by microscope, the diagnostic rate was 81.59%, there were 149 cases with lung field shadows and enlargement of hilum, and 142 cases with lung cancer were diagnosed by microscope. The diagnosis rate was 95.3%. Lungs There were 114 cases of portal mass and 107 cases of lung cancer were diagnosed by microscope. The diagnostic rate was 93.86%. In the discussion, the role and value of bronchoscopy in the diagnosis of lung cancer were presented, as well as the importance of correct acquisition by microscopy and the need for continuous investigation of undiagnosed cases.