经支气管针吸活检结合液基薄层细胞检查诊断肺癌45例分析

目的探讨经支气管针吸活检(TBNA)结合液基薄层细胞技术(TCT)对肺癌的诊断价值。方法回顾性分析2011年4月—7月在无锡市第四人民医院气管镜室行经支气管针吸活检术确诊的肺癌45例,穿刺针常规穿刺抽吸细胞行涂片细胞学诊断,然后将TCT液冲洗穿刺针,冲洗液行TCT检查。对比涂片法、TCT法和涂片法结合TCT法诊断肺癌的敏感性。结果 45例肺癌患者中40例(40/45,89%)在涂片法中找到癌细胞;36例(36/45,80%)在TCT法中找到癌细胞;5例(5/45,11.1%)仅在TCT法中找到癌细胞;9例(9/45,20%)仅在涂片法中找到癌细胞;31例(31/45,68.9%)在涂片法和TCT法中均找到癌细胞。单纯涂片法找癌细胞、单纯TCT法找癌细胞和涂片法结合TCT法诊断肺癌敏感性经统计学计算P0.05,后者可明显提高诊断肺癌的敏感性。结论经支气管针吸活检是一种诊断肺癌的安全有效的方法,常规细胞涂片结合液基薄层细胞学技术能提高诊断敏感性,值得临床推广应用。

Lung cancers diagnosed by combining transbronchial needle aspiration with thinprep cytologic test:an analysis of 45 cases

Objective To assess the value of lung cancer diagnosed by combining transbronchial needle aspiration with thinprep cytologic test. Methods Forty-five lung cancers were analysed retrospectively which were confirmed by transbronchial needle aspiration at the Wuxi No. 4 Peoples＇ Hospital bronchoscope room from April 2011 to July 2011. We smeard on plates and syringed needle by TCT liquid ＇after undergoing TBNA. We studied the diagnosis sensitivity of the three ways by means of only traditional way, only TCT and traditional way combining with TCT. Results In 45 cases, 40 cases（40/45,89% ）were found malignant cells by traditional way;36 cases（38/45,80% ） were found malignant cells by TCT;5 cases（5/45,11.1% ） by only TCT; 9 cases（9/45,20% ） by only traditional way;31 cases（31/45,68. 9% ） were found malignant cells by both traditional way and TCT. Statistical analyses of the difference in the diagnostic yield among the three ways were performed. A P-value lower than 0.05 was considered statistically significant. Combining traditional way with TCT could improve the sensitivity of diagnosis lung cancer. Conclusion TBNA is a safe and efficient technique which diagnoses the lung cancer. We can improve the sensitivity of diagnosing lung cancer by combining traditional way with TCT and it is worth generalizing in clinic.