关键词: 原发性肺癌, 纤支镜刷片, 痰液, 胸水, 灌洗液, 细胞学诊断

Abstract:

Objective To investigate the diagnosis significance of cytological determination with 4 different sample sources,such as bronchial brushing,fiberoptic bronchoscopy lavage fluid,pleural fluid and sputamentum,for lung cancer. Methods The samples from 156 patients with primary lung cancer with the 4 different sample sources were analyzed retrospectively. Results A total of 119 cases were diagnosed by bronchial brushing in 156 patients with primary lung cancer. The total positive rate was 76.3%,and the positive rates of squamous cell carcinoma（92.0%） and undifferentiated small cell carcinoma（84.6%） were the highest. A total of 31 cases were diagnosed by sputamentum,the total positive rate was 19.9%,and the positive rates of undifferentiated small cell carcinoma（46.2%） and adenosquamous carcinoma（100%） were the highest. A total of 95 cases were diagnosed by pleural fluid,the total positive rate was 60.9%,and the positive rate of adenocarcinoma（94.1%） was the highest. A total of 33 cases were dignosed by lavage fluid,and the total positive rate was 21.2%. By bronchial brushing,lavage fluid,sputamentum and pleural fluid for central type lung cancer,the positive rates were 93.1%,20.8%,22.8% and 44.5%,but the positive rates for peripheral lung cancer were 45.5%,21.8%,14.5% and 89.1%. The positive rate of bronchial brushing for central type lung cancer was significantly higher than that for peripheral lung cancer（P<0.01）,and that of pleural fluid for peripheral lung cancer was significantly higher than that for central type lung cancer（P<0.01）. The total positive rate could approach 94.9% by one or more positive samples as basis. Conclusions The combined determination with bronchial brushing,fiberoptic bronchoscopy lavage fluid,pleural fluid and sputamentum can improve the positive rate of lung cancer,which can provide reference for clinical diagnosis.

Key words: Primary lung cancer, Bronchial brushing, Sputamentum, Pleural fluid, Lavage fluid, Cytological diagnosis