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纤维支气管镜检查在肺癌诊断中的应用:支气管镜检查前后痰液、冲洗液、刷片及活检的比较

Fiberoptic bronchoscopy in the diagnosis of lung cancer comparison of pre-and post-bronchoscopy sputa, washings, bruchings and biopsies.

作者信息

Chopra S K, Genovesi M G, Simmons D H, Gothe B

出版信息

Acta Cytol. 1977 Jul-Aug;21(4):524-7.

PMID:269602
Abstract

Fiberoptic bronchoscopy (brushings, washings and biopsies) was performed and pre- and post-bronchoscopy sputum cytologies obtained on 70 patients with histopathologically proven lung cancer. Bronchoscopy, with its associated procedures performed in 52 patients with primary bronchogenic carcinoma, was diagnostic in 41 (79%). Of all the various methods of obtaining specimens, bronchial brushing and bronchial biopsy gave the highest percentage yield (67%). However, since brush specimens could be obtained from peripheral lesions under fluoroscopic guidance, a greater number of positive specimens were obtained by this procedure (34) than by forceps biopsy (25), making brushing more useful. Pre- and post-bronchoscopy sputa were positive and thus of value in two cases when brushing and biopsy were both negative. Bronchial washing did not add significantly to the yield of positives and could therefore be eliminated as an unnecessary cost-and time-consuming procedure. Fiberoptic bronchoscopy was not helpful in diagnosing mediastinal tumors (5), lung metastases (7) and bronchial adenomas (6).

摘要

对70例经组织病理学证实为肺癌的患者进行了纤维支气管镜检查(刷检、冲洗和活检),并在支气管镜检查前后获取了痰细胞学检查样本。在52例原发性支气管肺癌患者中进行了支气管镜检查及其相关操作,其中41例(79%)诊断明确。在所有获取标本的各种方法中,支气管刷检和支气管活检的阳性率最高(67%)。然而,由于刷检标本可在透视引导下从周围病变获取,通过该操作获得的阳性标本数量(34例)多于钳取活检(25例),这使得刷检更有用。在两例刷检和活检均为阴性的病例中,支气管镜检查前后的痰液呈阳性,因此具有价值。支气管冲洗对阳性率的提高没有显著作用,因此可作为一项不必要的、耗费成本和时间的操作而省去。纤维支气管镜检查对纵隔肿瘤(5例)、肺转移瘤(7例)和支气管腺瘤(6例)的诊断没有帮助。

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