Franke Karl-Josef, Nilius G, Ruhle K-H
Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, University of Witten/Herdecke, Ambrocker Weg 60, 58091 Hagen, Germany.
Eur J Med Res. 2009 Jan 28;14(1):13-7. doi: 10.1186/2047-783x-14-1-13.
The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial catheter aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.
We analysed the results of 51 consecutively examined patients (age 68.7 +/- 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 < or = 3 cm. Fluoroscopy provided guidance in biopsies for both techniques.
The mean diameter of the lesion was 3.7 +/- 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma < or = 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14).
Even in lesions < or = 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
获取用于诊断肺外周癌的组织学分析材料的常规方法是经支气管钳取活检（TBB）。经支气管导管抽吸（TBCA）获取用于细胞学检查的样本并未广泛应用。回顾性收集数据以确定TBCA与TBB相比在诊断恶性肿瘤方面的敏感性。
我们分析了连续51例接受两种方法检查的患者（年龄68.7±8.8岁）的结果。51例外周病变中有48例被证实为恶性，其中34例直径>3 cm，14例直径≤3 cm。两种技术的活检均在荧光镜引导下进行。
病变的平均直径为3.7±1.5 cm。48例肺癌患者中，通过TBCA能正确诊断36例，通过TBB能正确诊断21例（75%对44%，p<0.01，卡方检验）。两种方法联合应用时，48例患者中有39例被正确诊断。对于直径>3 cm的癌，TBCA的成功率为76%（26/34），TBB为56%（19/34）。对于直径≤3 cm的癌，TBCA的成功率为71%（10/14），TBB为14%（2/14）。
即使对于直径≤3 cm的病变，TBCA的应用成功率与直径>3 cm的病变相比仅略低。由于总体成功率较高，我们建议在肺外周癌的诊断过程中应用操作简便且成本低廉的TBCA方法。
