Yamamoto Suguru, Ueno Kiyonobu, Imamura Fumio, Matsuoka Hiroto, Nagatomo Izumi, Omiya Yasuhide, Yoshimura Mana, Kusunoki Yoko
Department of Pulmonary Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
Lung Cancer. 2004 Oct;46(1):43-8. doi: 10.1016/j.lungcan.2004.03.005.
Although ultrathin bronchoscopes are suggested to have comparable abilities to conventional bronchoscopes in diagnosing peripheral lung lesions, how to introduce ultrathin bronchoscopes into bronchoscopic examination is still to be determined. In our first study, 35 patients with peripheral lung lesions underwent ultrathin followed by conventional bronchoscopy to compare their diagnostic abilities. The diagnostic rate was 54.3% in conventional bronchoscopy alone, 60.0% in ultrathin bronchoscopy alone, and 62.8% in the combination of the two. In the next study, we introduced a rapid cytology test of the material obtained in conventional bronchoscopy. When malignant cells were not detected in the material by the rapid cytology, ultrathin bronchoscopy was immediately conducted. Thirty-two patients with negative rapid cytology were enrolled in this study. Ultrathin bronchoscopy resulted in diagnostic materials in 59.3% of these cases. Ultrathin bronchoscopes showed better access to the lesions than a brush or a curette introduced through conventional bronchoscopes. We conclude that ultrathin bronchoscopes have a comparable ability to conventional ones in diagnosing peripheral lung cancer even when used alone, and become a good complement to conventional ones by introducing the rapid cytology test.
尽管超薄支气管镜在诊断周围型肺病变方面被认为与传统支气管镜具有相当的能力，但如何将超薄支气管镜引入支气管镜检查仍有待确定。在我们的第一项研究中，35例周围型肺病变患者先接受了超薄支气管镜检查，随后进行了传统支气管镜检查，以比较它们的诊断能力。单独使用传统支气管镜的诊断率为54.3%，单独使用超薄支气管镜的诊断率为60.0%，两者联合使用的诊断率为62.8%。在接下来的研究中，我们引入了对传统支气管镜获取材料的快速细胞学检测。当快速细胞学检测在材料中未检测到恶性细胞时，立即进行超薄支气管镜检查。本研究纳入了32例快速细胞学检测为阴性的患者。超薄支气管镜在59.3%的这些病例中获得了诊断材料。与通过传统支气管镜引入的刷子或刮匙相比，超薄支气管镜显示出更好的到达病变部位的能力。我们得出结论，即使单独使用，超薄支气管镜在诊断周围型肺癌方面与传统支气管镜具有相当的能力，并且通过引入快速细胞学检测成为传统支气管镜的良好补充。
