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目的:探讨纤维支气管镜(纤支镜)检查在胸部影像学阴性的中央型肺癌早期诊断的临床价值。方法:回顾分析我院呼吸内科38例胸部影像学正常而经纤支镜检查确诊的中央型肺癌患者的临床表现、纤支镜下的表现及病理学、细胞学的改变。结果:38例患者的临床症状主要表现为咳嗽、咯血或咯血痰和胸痛;镜下表现:管壁浸润型24例(24/38)、增殖型14例(14/38),其中有6例表现为小菜花状,5例为息肉状,3例为小结节状;病理病理学及细胞学改变:鳞状细胞癌20例,腺癌12例,小细胞癌6例,刷检涂片细胞学检查阳性20例,其中6例提示腺癌、2例提示鳞癌,其它未能分型。结论:对胸部影像学正常的、不明原因的咳嗽、咳血痰、胸痛患者,应把纤支镜检查列为肺癌筛选的必要手段,以避免漏诊和误诊。
Objective: To investigate the clinical value of bronchoscopy (bronchoscopy) in the early diagnosis of central lung cancer with negative breast imaging. Methods: The clinical manifestations, pathological and cytological changes of central lung cancer diagnosed by fiberoptic bronchoscopy were retrospectively analyzed in 38 cases of thoracic imaging in our hospital. Results: The clinical manifestations of 38 patients were mainly cough, hemoptysis or hemoptysis sputum and chest pain. In microscopic examination, there were 24 cases (24/38) infiltrating the wall and 14 cases (14/38) proliferating, of which 6 Manifested as small cauliflower, 5 cases of polypoid, 3 cases of nodular; pathological and cytological changes: squamous cell carcinoma in 20 cases, adenocarcinoma in 12 cases, 6 cases of small cell carcinoma, brush smear Cytology positive in 20 cases, of which 6 cases of adenocarcinoma prompted, 2 cases of squamous cell carcinoma, the other failed to type. Conclusion: For patients with normal thoracic imaging, unexplained cough, hemoptysis and chest pain, bronchofiberscopy should be selected as a necessary tool for lung cancer screening to avoid misdiagnosis and missed diagnosis.