Linder J, Radio S J, Robbins R A, Ghafouri M, Rennard S I
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68105.
Acta Cytol. 1987 Nov-Dec;31(6):796-801.
To assess the utility of bronchoalveolar lavage as a technique for diagnosing lung cancer, 850 lavages from 421 patients were reviewed. Biopsy-proven lung carcinoma was present in 35 cases. Of these, 24 (68.6%) had cells diagnostic of malignancy on cytologic preparations of the bronchoalveolar lavage fluid. Agreement between cancer subtypes determined by lavage and by tissue biopsy was 79.1%; variation usually occurred between large cell undifferentiated carcinoma and adenocarcinoma, not with small cell anaplastic carcinoma. The subtype of tumors was most accurately determined by examination of Papanicolaou-stained slides. Reactive bronchial epithelium often mimicked carcinoma, but could be correctly identified by its characteristic cytomorphology. No false-positive diagnoses of lung cancer occurred in 386 patients. The sensitivity of bronchoalveolar lavage for the diagnosis of lung carcinoma is similar to that of transbronchial biopsy and Wang needle biopsy. Because bronchoalveolar lavage may detect opportunistic infections, interstitial lung diseases and malignant cells with a low morbidity, it is a useful tool to assess patients with pulmonary infiltrates.
为评估支气管肺泡灌洗术作为一种诊断肺癌的技术的实用性，对421例患者的850次灌洗进行了回顾。经活检证实的肺癌患者有35例。其中，24例（68.6%）在支气管肺泡灌洗液的细胞学标本中有诊断为恶性肿瘤的细胞。通过灌洗和组织活检确定的癌症亚型之间的一致性为79.1%；差异通常发生在大细胞未分化癌和腺癌之间，而非小细胞间变性癌。通过检查巴氏染色涂片能最准确地确定肿瘤亚型。反应性支气管上皮常类似癌，但可通过其特征性细胞形态学正确识别。386例患者未出现肺癌的假阳性诊断。支气管肺泡灌洗术诊断肺癌的敏感性与经支气管活检和王针活检相似。由于支气管肺泡灌洗术可能检测到机会性感染、间质性肺疾病和恶性细胞，且发病率较低，因此它是评估肺部浸润患者的一种有用工具。
