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目的探讨胸部X线呈现“三阻征”与中央型肺癌发病的关系。方法对326例胸部X线呈现“三阻征”的肺癌高危者用螺旋CT、纤维支气管内窥镜以及痰细胞、活体和手术切除等进行中央型肺癌筛查。结果确诊为中央型肺癌者32例,患病率为9.8%;其中阻塞性肺炎21例(占12.5%),阻塞性肺气肿7例(占8.4%),阻塞性肺不张4例(占5.3%);病理类型为鳞癌16例(占50.0%),小细胞癌9例(占28.1%),腺癌4例(占12.5%),其他3例(占9.4%),首发或主要症状为胸痛者12例(占37.5%),咳嗽10例(占31.3%),咳痰5例(占15.6%),发热3例(占9.4%),血丝痰2例(占6.2%)。结论胸部X线呈现“三阻征”与中央型肺癌的发病有关,重视筛查可提高肺癌的早期检出率。
Objective To investigate the relationship between the appearance of chest X-ray and the sign of “three resistances” and the incidence of central lung cancer. Methods A total of 326 lung cancer patients with chest X-ray showed “three resistance sign” were screened for central lung cancer with spiral CT, fibrobronchoscopy and sputum cells, in vivo and surgical excision. Results 32 cases were diagnosed as central lung cancer with a prevalence of 9.8%. Among them, 21 cases were obstructive pneumonia (12.5%), 7 cases were obstructive pulmonary emphysema (8.4%), 4 cases were obstructive pulmonary atelectasis Accounting for 5.3%). The pathological types were squamous cell carcinoma in 16 cases (50.0%), small cell carcinoma in 9 cases (28.1%), adenocarcinoma in 4 cases (12.5%) and the other 3 cases (9.4% The main symptoms were chest pain in 12 cases (37.5%), cough in 10 cases (31.3%), sputum in 5 cases (15.6%), fever in 3 cases (9.4%) and bloody sputum in 2 cases (6.2% . Conclusion Chest X-ray showed “three resistance signs ” and the incidence of central lung cancer, emphasis on screening can improve the early detection rate of lung cancer.