【摘要】 目的　提高纤支镜检查和胸部 CT检查对中央型肺癌诊断的意义 ,并探讨它们之间与病理类型的关系。方法　分析 1995年 10月到 1997年 6月中央型肺癌 10 0例的临床资料 ,所有病例均行纤支镜检查和胸部 CT检查 ,检查间隔时间不超过一周并与病理类型比较。结果　中央型肺癌 10 0例 ,男性 6 1例 ,女性 39例 ;其中鳞癌 46例 ,腺癌 2 7例 ,鳞腺癌 8例 ,小细胞癌 4例 ,肺泡癌 3例 ,未能分型 12例。纤支镜直接征象 :鳞癌 84.78% (39/4 6 ) ,腺癌 74.0 7%(2 0 /2 7) ,鳞腺癌 75 % (6 /8) ,肺泡细胞癌 6 6 .6 7% (2 /3) ,小细胞癌 5 0 % (2 /4 ) ,未能分型 6 6 .6 7% (8/12 )。间接征象 :腺癌 2 5 .93% (7/2 7) ,鳞癌 15 .2 2 % (7/4 6 ) ,鳞腺癌 2 5 % (2 /8) ,小细胞癌 5 0 % (2 /4 ) ,未能分型 33.33% (4 /12 )。CT检查发现异常 97例 ,只有 2例 FOB检查镜下未见异常 ,CT发现支气管狭窄、阻塞、截断 ,支气管腔内有肿块影为 2 2 % (2 2 /10 0 )。结论　中央型肺癌以男性多见 ,病理类型多为鳞癌 ,CT与纤支镜检查各有长处 ,FOB能直接见到气管内的病变 ,并钳取组织检查获得病理 ,但很难进入较小支气管 ,CT检查能发现块影形态以及纵隔肺门淋巴结肿大 ,两者结合能提高中央型肺癌的诊断水平。更多还原

【Abstract】 Objective:To improve the diagnostic significance of the central lung cancer by fiberbronchoscope(FOB)and chest CT and study the relationship between the diagnostic results and their pathological types Methods:The clinical data of 100 cases of the central lung cancer collected from oct.1995 to Jun.1997,was analysed by fiberbronchoscopy and CT within a weeks interval,and made a comparison between their results and pathological types.Results:The pathological findings showed that,of 100 cases(61 males,39 females),46 cases were squamous cell carcinoma,27 adenocarcinoma,8 mixed squamo adenocarcinoma,4 small cell lung cancer,3 pulmonary alveolar carcinoma and 12 unidentified type.The fiberbronchoscopic direct symptom showed the squamous cell carcinoma was 84 78%(39/46),the adenocarcinoma was 74 07%(20/27),the squamo adenocarcinoma was 25%(2/8),the pulmonary alveolar carcinoma was 66 67%(2/3),the small cell lung cancer was 50%(2/4),the unidentified type was 66 67%(8/12).The fiberbronchoscopic indirect symptom showed the adenocarcinoma was 25 93%(7/27),the squamous cell carcinoma was 15 22%(7/46),the squamoadenocarcinoma was 25%(2/8),the small cell lung carcinoma was 50%(2/4)and the the unidentified type was 33 33%(4/12).97 abnormal cases were found by CT and only 2 cases were normal by FOB.CT results indicated that the bronchus appeared narrow,occlusion and interuption.22 cases appeared mass shadow in bronchus.Conclusion:Most of the central lung carcinoma in which pathological type was the squamous cell carcinoma,appeared in male.Two examines have their good quality,i.e.the disease in bronchus could be directly found and analysed pathologically by FOB,which was difficult to be entered to the small bronchus.The shape of mass shadows and the swelling of the mediastinum Lymph nodes could be observed by CT.The above mentioned results showed the diagnostic level of the central lung carcinoma was raised by combining with two methods.更多还原