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目的:回顾性分析肺癌镜下分型与组织学类型的关系,并探讨纤维支气管镜检查技术对肺癌诊断价值.方法: 对2017年6月至2018年10月就诊于我院呼吸内科进行纤维支气管镜检查的158例肺病患者的相关临床资料进行回顾性分析,最终以病理学、细胞学或免疫组织化学确诊作为金标准,计算支气管镜活检(transbronchia1 bioPsy, TBB)、刷检(bronchia1 brushing, BB)、肺泡灌洗(bronchoa1veo1ar 1avage, BAL)或联合取材诊断的阳性率.结果: 94例肺癌患者镜下分型依次为:增生型(47. 9% , 45/94)、浸润型(21. 3% , 20/94)、混合型(20. 2% , 19/94)、正常型(9. 6% , 9/94)和管外压迫型(1. 1% , 1/94).增生型、浸润型、混合型均以鳞癌最多见,分别占57. 8% 、35. 0% 、47. 4% ,均显著高于腺癌和小细胞癌构成比(均P<0. 05).而正常型以未分型癌(44. 4% )和鳞癌(33. 3% )多见. TBB的活检总体阳性率为78. 8% (63/80),显著高于BB活检总体阳性率(56. 3% ,45/80,χ2 =9. 231, P=0. 002)和BAL活检总体阳性率(0. 0% ,0/2,χ2 =9. 804,P=0. 002).鳞癌患者的TBB活检阳性率高于BB活检阳性率(84. 1% Vs 63. 6% ,χ2 =4. 768, P=0. 029),腺癌患者的TBB活检阳性率高于 BB活检阳性率(57. 1% Vs 7. 1% ,χ2 =8. 023, P=0. 005);而小细胞癌患者TBB和 BB活检阳性率之间差异无统计学意义(81. 8% Vs 72. 7% , χ2 =0. 518, P=0. 472).鳞癌、腺癌和小细胞癌患者TBB+BB联合诊断的活检阳性率均明显高于TBB和BB单独诊断(均P<0. 05).结论:纤维支气管镜检查是肺癌主要的诊断方法.为了提高早期肺癌的诊断率,需要合理选择活检技术,必要时需要联合应用多项诊断技术.“,”To retrosPective1y ana1yze the re1ationshiP between endoscoPic and histo1ogica1 tyPe of 1ung cancer, and ex-P1ore the diagnostic va1ue of fiberoPtic bronchoscoPy in 1ung cancer. Methods: We retrosPective1y ana1yzed the c1inica1 data of 158 Pa-tients with Pu1monary diseases who underwent fiberoPtic bronchoscoPy from June 2017 to October 2018 in the DePartment of ResPiratory Medicine in our hosPita1. Patho1ogy, cyto1ogy or immunohistochemistry was regarded as the go1d standard, and the Positive rate of transbronchia1 bioPsy (TBB), bronchia1 brushing (BB), bronchoa1veo1ar 1avage (BAL) or combined diagnosis were ca1cu1ated. Re-suIts: A tota1 of 94 cases of 1ung cancer were c1assified as Pro1iferative (47. 9% , 45/94), infi1trating (21. 3% , 20/94), mixed (20. 2% , 19/94 ), norma1 ( 9. 6% , 9/94 ) and extraducta11y comPressed ( 1. 1% , 1/94 ), resPective1y. Squamous ce11 carcinoma were main1y Pro1iferative ( 57. 8% ), infi1trating (35. 0% ) or mixed (47. 4% ). The constituent ratio of squamous ce11 carcinoma to the 3 tyPes were significant1y higher (P<0. 05) than those of adenocarcinoma to them and those of sma11 ce11 carcinoma to them, resPective1y. The norma1 tyPe was more common in unc1assified carcinoma (44. 4% ) and squamous ce11 carcinoma (33. 3% ). The overa11 Positive rate of TBB was 78. 8% (63/80) which was significant1y higher than that of BB bioPsy (56. 3% , 45/80, χ2 =9. 231, P=0. 002) and that of BAL bioPsy (0. 0% , 0/2, χ2 =9. 804, P=0. 002). The Positive rate of TBB in squamous ce11 carcinoma Patients was significant1y higher than that in those by BB bioPsy (84. 1% Vs 63. 6% , χ2 =4. 768, P=0. 029). The Positive rate of TBB in adenocarcinoma Patients was significant1y higher than that in those by BB bioPsy (57. 1% Vs 7. 1% , χ2 = 8. 023, P=0. 005). There was no statistica11y significant difference between the Positive rates of TBB and BB bioPsy in sma11 ce11 carcinoma Patients (81. 8% Vs 72. 7% , χ2 =0. 518, P=0. 472). The Positive rates of TBB + BB bioPsy in Patients with squamous ce11 carcinoma, adenocarcinoma or sma11 ce11 carcinoma were significant1y higher (P<0. 05) than those in Patients by TBB or BB a1one, resPective1y. ConcIusion: FiberoPtic bronchoscoPy is the main diagnos-tic method for 1ung cancer. In order to imProve the diagnostic rate of ear1y 1ung cancer, it is necessary to se1ect bioPsy techniques rea-sonab1y and aPP1y mu1tiP1e diagnostic techniques joint1y when necessary.