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目的分析CT提示肺部占位高度可疑肺癌患者CT影像改变与纤维支气管镜下改变及诊断结果,提高肺部占位患者诊断及鉴别诊断水平。方法对264例CT提示肺部占位高度可疑肺癌患者纤维支气管镜检查、最终诊断结果及肺部CT影像表现进行回顾性分析。结果264例CT提示肺部占位患者镜下见异常改变264例,其中腔内外生性肿物127例,纤维支气管镜钳检及刷检确诊为肺恶性肿瘤111例,其他途径诊断肺恶性肿瘤7例;浸润改变88例,经纤维支气管镜钳检及刷检确诊肺恶性肿瘤55例,其他途径诊断为肺恶性肿瘤12例、诊为肺结核3例,非何杰金氏淋巴瘤1例,胸腺瘤1例;支气管黏膜充血或伴靡烂49例,经纤维支气管镜钳检及刷检确诊肺恶性肿瘤14例,其他途径诊断肺恶性肿瘤14例,炎性假瘤5例,肺结核5例。结论①CT提示肺部占位肺癌可疑患者大都是肿瘤,诊断符合率为82.2%,恶性肿瘤中以鳞癌较多见,少部分可能为结核瘤或炎性假瘤;②镜下新生物型较浸润型改变非特异改变确诊率高;③多种检查方法结合能提高肺部病变的诊断成功率。
Objective To analyze the changes of CT images and the results of bronchofibroscopy in patients with lung cancer with high suspicious lung occupancy, and to improve the diagnosis and differential diagnosis of lung space occupying patients. Methods A retrospective analysis was performed on 264 cases of CT lung cancer patients with suspected lung cancer suspicious of fiberoptic bronchoscopy, the final diagnosis and pulmonary CT images were retrospectively analyzed. Results 264 cases of lung cancer patients showed 264 cases of abnormal changes in the microscopic lesions, including 127 cases of endometriosis, fiberoptic bronchoscopy and brush examination of 111 cases of lung malignancies, other ways to diagnose lung cancer 7 Cases; infiltration change in 88 cases, fiberoptic bronchoscopy and brush examination confirmed 55 cases of lung cancer, other pathological diagnosis of lung cancer in 12 cases, diagnosed as pulmonary tuberculosis in 3 cases, 1 case of non-Hodgkin’s lymphoma, thymus 1 case of tumor, 49 cases of bronchial mucosal congestion or complication, 14 cases of lung malignancy diagnosed by fiberoptic bronchoscopy and brush examination, 14 cases of lung malignancy, 5 cases of inflammatory pseudotumor and 5 cases of pulmonary tuberculosis. Conclusion ① CT prompted lung space occupying suspicious patients are mostly tumors, the diagnostic coincidence rate was 82.2%, with squamous cell carcinoma is more common, a small part may be tuberculoma or inflammatory pseudotumor; ② microscopy of new biological type than Invasive type of non-specific changes in the diagnosis of high rate of change; ③ combination of a variety of inspection methods can improve the diagnostic success rate of lung lesions.