支气管镜检查在痰涂片阴性肺结核、间质性肺疾病和肺恶性肿瘤病例评估中的作用：712例回顾性研究
Role of bronchoscopy in evaluation of cases with sputum smear negative pulmonary tuberculosis, interstitial lung disease and lung malignancy: A retrospective study of 712 cases.
作者信息
Kumar Raj, Gupta Nitesh
机构信息
Professor and Head of the Department, Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, Asthma and Immunology, V P Chest Institute, University of Delhi, Delhi 110007, India.
Resident, Department of Respiratory Allergy and Applied Immunology, V P Chest Institute, University of Delhi, Delhi 110007, India.
出版信息
Indian J Tuberc. 2015 Jan;62(1):36-42. doi: 10.1016/j.ijtb.2015.02.006. Epub 2015 Mar 14.
BACKGROUND
The introduction of flexible bronchoscope has revolutionized the field of pulmonary medicine and is a standard instrument used for diagnostic purpose. A retrospective analysis of the clinico-radiological profile, indication, biopsy procedure and complications, for patients undergoing bronchoscopy at one of the respiratory unit at a tertiary care center in India.
METHODS
Retrospective analysis of 712 bronchoscopies was done in regard to demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on basis of bronchoscopy inspection and histopathological specimen obtained from transbronchial (TBLB), endobronchial biopsy (EBLB) and cytology specimen by transbronchial needle aspiration (TBNA). Furthermore, diagnostic yield of each biopsy procedure and their combination was evaluated.
RESULTS
Of 712 patients undergoing bronchoscopy, the pathological diagnosis was achieved in 384 (53.93%). Of 384 diagnosed cases, the clinic-radio-pathological diagnosis of pulmonary tuberculosis in 88 (22.19%), interstitial lung disease (ILDs) in 226 (58.85%), and lung cancer in 70 (18.22%) cases. Of 116 sputum smear negative tuberculosis patients, 88 (75.86%) were diagnosed to be pulmonary tuberculosis; the contribution of BAL being 71.59%. Of 226 ILDs, sarcoidosis was most common 148/226 (65.48%). Among 70 lung cancer diagnosed cases, squamous cell carcinoma was most common (54.28%).
CONCLUSION
The results from current study reemphasizes on the diagnostic utility as well as safety of the bronchoscopy procedure.
背景
可弯曲支气管镜的引入彻底改变了肺部医学领域，是用于诊断目的的标准器械。对印度一家三级医疗中心呼吸科接受支气管镜检查的患者的临床放射学特征、适应症、活检程序及并发症进行回顾性分析。
方法
对712例支气管镜检查进行回顾性分析，内容包括人口统计学特征、临床和放射学表现及诊断适应症。根据支气管镜检查及经支气管肺活检（TBLB）、支气管内活检（EBLB）和经支气管针吸活检（TBNA）获得的组织病理学标本分析结果。此外，评估每种活检程序及其组合的诊断率。
结果
712例接受支气管镜检查的患者中，384例（53.93%）获得病理诊断。在384例确诊病例中，临床放射病理诊断为肺结核的有88例（22.19%），间质性肺疾病（ILDs）226例（58.85%），肺癌70例（18.22%）。116例痰涂片阴性的肺结核患者中，88例（75.86%）被诊断为肺结核；支气管肺泡灌洗（BAL）的贡献为71.59%。在226例ILDs中，结节病最常见，为148/226（65.48%）。在70例确诊的肺癌病例中，鳞状细胞癌最常见（54.28%）。
结论
本研究结果再次强调了支气管镜检查程序的诊断效用和安全性。
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