论文部分内容阅读
多年来对肺恶性肿瘤可疑者采用硬质支气管镜和病理活组织检查,作诊断的敏感性已有定论。在软质光源纤维支气管镜下,用刷擦活组织的检查结果协助诊断,目前虽认为有高度的敏感性,但至今无可供参考的直接对比资料。肺肿瘤可疑者116例,平均年龄61～62岁患者,在全身麻醉下,由掌握两种支气管镜检查的熟练医师,连续先用光源纤维支气管镜,在肺段开口异常部位用毛刷刷擦后,即取出支气管镜和毛刷。再立即将毛刷在玻片上摩擦成涂片,固定染色检查。随后,再插入硬质支气管镜,钳出已被怀疑的活组织,经石腊切片作病理组织学检查。经对连续采取的两种活组织标本对比检验后,共有99/116例证实为恶性肿瘤。其中经硬质镜活组织病理检查发现者50例(50%);而用软质镜刷擦细胞涂片证实者81例(81.8%),两种检验均阳性者46例(46%);而刷细胞与病理检查单独阳性者分别为35与4例。从而用直接对比法证实了刷细胞检查的阳性率显著地高于组织病理法的论断。由于标本均取自同一可疑部位,而阳性结果之所以如此的悬殊,作者
For years, the susceptibility to diagnosis has been determined by using hard bronchoscopes and pathological biopsy for suspicious persons with malignant lung tumors. Under the soft light source fiberoptic bronchoscope, the diagnostic results of brushing the living tissue assist in the diagnosis. Although high sensitivity is currently considered, no direct comparison data has been available for reference. There were 116 patients with suspected lung tumors and patients with an average age of 61 to 62 years. Under general anesthesia, skilled physicists with two types of bronchoscopic examinations used a light source fiberoptic bronchoscope to brush with the brush at the anomalous site of the lung segment. After that, remove the bronchoscope and brush. Immediately rub the brush on the slide to a smear and fix it for staining. Subsequently, a hard bronchoscope was inserted and the suspected living tissue was clamped and paraffin sections were used for histopathological examination. After comparing two consecutive biopsy specimens, a total of 99/116 demonstrated malignancy. Among them, 50 cases (50%) were found by hard-tissue biopsy, while 81 cases (81.8%) were confirmed by soft-mirror brushing of cell smears, and 46 cases (46%) were positive by both tests. The brush cells and pathological examination were positive in 35 and 4 cases respectively. Thus, the direct contrast method confirmed that the positive rate of brush cell examination was significantly higher than that of histopathology. Since the specimens were all taken from the same suspicious site, the positive results were so disparate that the authors