The Bronchial Needle Aspiration Biopsy In The Diagnosis Of Lung Cancer Specimen

BackgroundLung cancer is one of the world within the scope of one of the highest morbidity andmortality of malignant tumors, about two-thirds of patients at the time of diagnosis has beenlate, have no chance of surgery, radiation and chemotherapy and molecular targeted therapybecome the main treatment of late direction and specific treatment depends on the choice oflung tissue pathology types. How to acquire in the case of non-surgical lung cancer tissuesamples for pathological diagnosis and molecular target detection has important significance.ObjectiveExplore the bronchoscope needle aspiration biopsy (TBNA) in the diagnosis of lungcancer value, EGFR gene mutation detection analysis TBNA biopsy specimens, and furtherguide clinical treatment.Methods1. Select the chest CT shows in lung lesions and diagnosis of129cases of patients withlung cancer, among which99were male,30cases of female age326~7years old, themedian age56years, using TBNA+clamp inspection+brush inspection+lavage jointmaterials inspection.2. Select the chest C T shows combination of39patients with mediastinal lymph nodeenlargement, line TBNA based inspection.3. The application of fluorescence PCR technique to more than168cases of TBNAEGFR gene detects tissue samples.4. Organize more cases of clinical pathology and molecular index (based methods,histologic type, genetic mutations), statistical analysis of different materials way under thebronchoscope diagnosis positive rate and EGFR mutation rate in different tissue types.Result1.129patients in the study, the TBNA, pliers, brush inspection, confirmed127cases of lung cancer, after lavage TBNA confirmed104cases of positive rate80.6%(104/129); Clampinspection diagnosis of90cases were69.8%(90/129); Brush inspection lavage of70caseswere54.3%(70/129); Lavage confirmed63cases, the positive rate48.8%(63/129), fourbased method combined the positive rate is98.4%(127/129). Of the127cases confirmed,38patients with adenocarcinoma and49patients with squamous carcinoma, small cell carcinomaof the32cases,8patients were not parting. The other2cases of atypical hyperplasia;2.39patients with mediastinal lymph node enlargement patients with mediastinal lymphnode TBNA, diagnosis were82.05%(32/39), of which the other7cases of cancer cells wasnot found; Diagnosis of32cases,10cases of adenocarcinoma patients,13cases of squamouscarcinoma, small cell carcinoma of the9cases.3.168cases of TBNA takes organization, EGFR positive44cases (34.1%),21cases ofadenocarcinoma (70.0%), squamous cell carcinomas in16cases (41.0%), small cellcarcinoma in5cases (20.0%), not parting in2cases (25.0%), noncancerous tissues in0.Conclusion1. TBNA in diagnosis of lung cancer patients has a high positive rate of diagnosis, andhigher than the other under the bronchoscope based method, can obviously improve thepositive rate of patients with lung cancer diagnosis.2. TBNA in patients with mediastinal lymph node enlargement has higher positive rate ofdiagnosis, the patients with lung cancer in the preoperative staging accurately.3. Specimens of TBNA, EGFR free expression, not cancerous lung tissues in highexpression in lung cancer, the expression in NSCLC were higher than that of SCLC,expression positive rate is higher than squamous cell carcinomas in lung adenocarcinoma,EGFR testing conclusion is consistent with surgical removal of the specimen.