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目的探讨胸部X线“三阻征”联合纤维支气管镜(以下简称纤支镜)筛查中央型肺癌的价值。方法对326例胸部X线仅呈现“三阻征”的肺癌高危者(观察组)和300例“无三阻征”的肺癌高危患者(对照组)均用纤维支气管内窥镜检查,发现支气管受侵后取活检行病理检查。结果观察组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,阻塞性肺气肿7例,阻塞性肺不张4例;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%)。对照组确诊为中央型肺癌2例,均为鳞癌,患病率为0.66%,两组统计学对比有高度显著性(χ2=25.461,P<0.01)。结论胸部X线“三阻征”是中央型肺癌的早期征像,联合纤支镜筛查,对早期发现和早期诊断、提高生存率有重要价值。
Objective To investigate the value of chest X-ray and “three resistance sign” combined with bronchofibroscopy (hereinafter referred to as bronchofiberscopy) in the screening of central lung cancer. Methods Thirty-six patients with high risk of lung cancer (observation group) and 300 high risk patients without lung cancer (control group) with chest X-ray showing only “three resistance sign” were treated with fiberoptic bronchoscopy Check and found that after the invasion of bronchial biopsy line examination. Results The observation group was diagnosed with central lung cancer in 32 cases, the prevalence was 9.8%; of which 21 cases of obstructive pneumonia, obstructive pulmonary emphysema in 7 cases, obstructive atelectasis in 4 cases; pathological type squamous cell carcinoma in 16 cases Accounting for 50.0%), small cell carcinoma in 9 cases (28.1%), adenocarcinoma in 4 cases (12.5%) and other 3 cases (9.4%). The control group was diagnosed as central lung cancer in 2 cases, all squamous cell carcinoma, the prevalence was 0.66%, the two groups were statistically significant (χ2 = 25.461, P <0.01). Conclusion The chest X-ray “three resistance sign” is an early sign of central lung cancer. Combined with fiberoptic bronchoscopy, it has important value in early detection and early diagnosis, and improves survival rate.