胸部X线、CT和纤维支气管镜对肺癌诊断的应用研究(1)
[摘要] 目的 分析和研究胸部X线、螺旋 CT及纤维支气管镜在诊断中的价值和意义。 方法 随机抽取于2013年1月—2015年1月间在该院就诊的140例肺癌患者作为研究对象，并根据检查方法的不同分为X线、CT、支气管镜，所有患者均进行以上检查，对比和分析各种方法在诊断中的准确性。结果 X线检查的准确率为171/235(72.77%)，CT检查的准确率为211/235(89.79%)，纤维支气管镜的准确率为221/235(94.04%)，CT高于X线，差异有统计学意义(χ2=5.37，P<0.05)；纤维支气管镜高于X线，差异有统计学意义(χ2=6.81，P<0.05)；纤维支气管镜虽高于CT，差异有统计学意义(χ2=0.67，P<0.05)。60%以上的肺癌患者通过X线即可确诊，CT在周围型肺癌诊断中准确率更高，而纤维支气管镜则在中心型肺癌中的诊断准确性更高。 结论 临床上在对肺癌初诊筛查中，可将胸部X线放在第一位，CT和纤维支气管镜作为进一步检查，这对提高临床对肺癌的确诊率具有重要意义。
[关键词] 肺癌；X线计算机；断层摄影术；支气管镜检查；检出率
[中图分类号] R734 [文献标识码] A [文章编号] 1674-0742(2015)09(c)-0179-02
[Abstract] Objective To analyze and discuss the meaning and value of chest X-ray， CT and fibrobronchoscope. Methods Selected 140 cases of patients with lung cancer in our hospital from January 2013 to January 2015 as a study object， according to the different of imaging detection scheme divided into CT group， X-gray group and fibrobronchoscope group， and analysis of the effect of the three detection methods in the treatment of patients. Results The accuracy rate of X-ray was 171/235 (72.77%)， accuracy of CT examination for 211/235 (89.79%)， the accuracy rate of fiberoptic bronchoscopy for 221/235 (94.04%) was higher than that of X-ray， CT， there was significant difference(χ2=5.37， P<0.05)； fiberoptic bronchoscopy was higher than that of X-ray， there were statistically significant differences (χ2=6.81，P<0.05)； fiberoptic bronchoscopy the mirror is higher than that of CT， but the difference was not statistically significant(χ2=0.67， P<0.05).Over 60% lung cancer patients can be clinically diagnosed only by chest X-ray， the accurate rate of peripheral lung cancer can be diagnosed by CT while central lung cancer can be diagnosed by fibrobronchoscope. Conclusion It was showed that Chest X-ray should be used firstly in the diagnosis of lung cancer， and CT or fibrobronchoscope can greatly improve the diagnostic accuracy of lung cancer， which is worthy of promotion and application.
[Key words] Lung cancer； Spiral CT； X-ray； Fibrobronchoscope； Detection rate
近年来随着环境污染加重和人们生活方式的改变，统计研究发现肺癌的发生率呈逐年增加的趋势[1-2]。在我国肺癌的诊断方法很多，临床常用的包括胸部X线、CT及纤维支气管镜。虽然胸部X线应用比较普遍，但是由于其易漏诊因此其准确性受到怀疑。目前CT扫描技术已经被普遍用来诊断肺部占位性病变的良恶性，以成为目前无创检查的重要手段之一。该研究分析2013年1月—2015年1月在该院就诊的140例肺癌患者三种影像学检测方法的临床资料，取得了一定的研究结果，现报道如下。
1 资料与方法
1.1 一般资料
按照随机双盲的原则选取就诊于该院的140例肺癌患者作为研究对象，所有患者已经过穿刺活检病理确诊为肺癌，其中男性患者78例，女性患者62例；患者年龄在45～80岁，平均(53.9 ±9.2) 岁；患者病理类型主要为肺鳞癌和肺腺癌，其中鳞癌患者81例，腺癌患者59例；病变直径0.9～7.2 cm，平均直径(2.3±0.6)cm。所有患者的一般资料比较差异无统计学意义(P>0.05)，具有可比性。 (董乐 张锡海 韩璐璐 刘钊)
[关键词] 肺癌；X线计算机；断层摄影术；支气管镜检查；检出率
[中图分类号] R734 [文献标识码] A [文章编号] 1674-0742(2015)09(c)-0179-02
[Abstract] Objective To analyze and discuss the meaning and value of chest X-ray， CT and fibrobronchoscope. Methods Selected 140 cases of patients with lung cancer in our hospital from January 2013 to January 2015 as a study object， according to the different of imaging detection scheme divided into CT group， X-gray group and fibrobronchoscope group， and analysis of the effect of the three detection methods in the treatment of patients. Results The accuracy rate of X-ray was 171/235 (72.77%)， accuracy of CT examination for 211/235 (89.79%)， the accuracy rate of fiberoptic bronchoscopy for 221/235 (94.04%) was higher than that of X-ray， CT， there was significant difference(χ2=5.37， P<0.05)； fiberoptic bronchoscopy was higher than that of X-ray， there were statistically significant differences (χ2=6.81，P<0.05)； fiberoptic bronchoscopy the mirror is higher than that of CT， but the difference was not statistically significant(χ2=0.67， P<0.05).Over 60% lung cancer patients can be clinically diagnosed only by chest X-ray， the accurate rate of peripheral lung cancer can be diagnosed by CT while central lung cancer can be diagnosed by fibrobronchoscope. Conclusion It was showed that Chest X-ray should be used firstly in the diagnosis of lung cancer， and CT or fibrobronchoscope can greatly improve the diagnostic accuracy of lung cancer， which is worthy of promotion and application.
[Key words] Lung cancer； Spiral CT； X-ray； Fibrobronchoscope； Detection rate
近年来随着环境污染加重和人们生活方式的改变，统计研究发现肺癌的发生率呈逐年增加的趋势[1-2]。在我国肺癌的诊断方法很多，临床常用的包括胸部X线、CT及纤维支气管镜。虽然胸部X线应用比较普遍，但是由于其易漏诊因此其准确性受到怀疑。目前CT扫描技术已经被普遍用来诊断肺部占位性病变的良恶性，以成为目前无创检查的重要手段之一。该研究分析2013年1月—2015年1月在该院就诊的140例肺癌患者三种影像学检测方法的临床资料，取得了一定的研究结果，现报道如下。
1 资料与方法
1.1 一般资料
按照随机双盲的原则选取就诊于该院的140例肺癌患者作为研究对象，所有患者已经过穿刺活检病理确诊为肺癌，其中男性患者78例，女性患者62例；患者年龄在45～80岁，平均(53.9 ±9.2) 岁；患者病理类型主要为肺鳞癌和肺腺癌，其中鳞癌患者81例，腺癌患者59例；病变直径0.9～7.2 cm，平均直径(2.3±0.6)cm。所有患者的一般资料比较差异无统计学意义(P>0.05)，具有可比性。 (董乐 张锡海 韩璐璐 刘钊)