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目的:探讨胸部CT、纤维支气管镜及痰脱落细胞检查诊断不同病理类型中央型肺癌的价值。方法:选择胸部X线检查提示肺门占位、拟诊中央型肺癌360例,均进行胸部CT、纤维支气管镜及痰脱落细胞检查,以术后或穿刺病理检查结果为准,比较以上3种检查手段诊断不同病理类型中央型肺癌的价值。结果:确诊肺癌320例。胸部CT、纤维支气管镜诊断中央型肺癌的特异性分别为89.5%、90.4%,均非常显著高于痰脱落细胞检查的40.8%(P<0.01);3种方法联合检查的特异性为98.5%,显著高于单项检查(P<0.05)。胸部CT、纤维支气管镜诊断中央型肺癌的敏感度分别为90.3%、86.8%,非常显著高于痰脱落细胞检查48.6%(P<0.01)。痰脱落细胞学检查对腺癌、腺鳞癌诊断的阳性率显著高于其他病理类型(P<0.05);胸部CT、纤维支气管镜对不同病理类型肺癌的诊断阳性率显著不差异(P>0.05)。结论:胸部CT、纤维支气管镜对于中央型肺癌均是较好的诊断手段,且对不同病理类型诊断价值相似。
Objective: To investigate the value of chest CT, fiberoptic bronchoscopy and sputum exfoliated cells in the diagnosis of central lung cancer of different pathological types. Methods: Thorax X-ray examination was performed to indicate the hilar occupying position. 360 cases of central lung cancer were suspected to be diagnosed. Thoracic CT, bronchofibroscopy and sputum exfoliated cells were examined. The postoperative or biopsy results were compared. Check the value of diagnosis of different pathological types of central lung cancer. Results: 320 cases of lung cancer were diagnosed. The specificity of chest CT and fiberoptic bronchoscopy in diagnosing central lung cancer were 89.5% and 90.4%, respectively, which were significantly higher than those of sputum exfoliated cells (40.8%, P <0.01). The specificity of the three methods was 98.5% , Significantly higher than single examination (P <0.05). The sensitivity of chest CT and fiberoptic bronchoscopy in the diagnosis of central lung cancer were 90.3% and 86.8%, respectively, which were significantly higher than those in sputum exfoliated cells (48.6%, P <0.01). The positive rates of sputum cytology in diagnosis of adenocarcinoma and adenosquamous carcinoma were significantly higher than those in other pathological types (P <0.05). The positive rates of CT and fiberoptic bronchoscopy in diagnosing lung cancer with different pathological types were significantly different (P> 0.05 ). Conclusion: Chest CT and fiberoptic bronchoscopy are both good diagnostic methods for central lung cancer and have similar diagnostic value for different pathological types.