Clinical Value Of Transbronchial Needle Aspiration Combined With Bronchoscopic Forceps And Brush Biopsy In The Diagnosis Of Lung Cancer

Objective:To investigate the diagnostic value of transbronchial needle aspiration(TBNA)combined with bronchoscopic forceps biopsy and brush biopsy for lung cancer.Methods:The clinical data of 274 patients undergoing bronchoscopy from September 2016 to February 2018 in our hospital were retrospectively reviewed.The bronchoscopic forceps,brush tests,transbronchial needle biopsy,and combined methods were performed.The positive results obtained were analyzed and the positive rates of lung cancer diagnosed by different methods were compared.Results:1.274 patients were diagnosed by bronchoscopy in diagnosis of lung cancer in 226 cases,and the positive rate was 82.48%.From the pathological type of lung cancer diagnosed,Squamous cell carcinoma is still the most common cancer,accounting for 36.28%,followed by adenocarcinoma(28.76%),small cell lung cancer(25.66%)and unknown types of lung cancer(9.29%).Among them,lung cancers that are infiltrated only by cancer cells that are difficult to classify by cytology and/or histology are classified as unidentified lung cancers.2.Comparison of positive rates of lung cancer diagnosed by bronchoscopy with different methods.After the chi-square analysis,the positive rates of lung cancer diagnosed by different methods were different.The positive rate of bronchoscopic biopsy,brush biopsy and TBNA in diagnosis of lung cancer were 70.06%,47.43%and 54.36%,the positive rate of forceps biopsy and brushing bronchoscopy was 72.88%,the positive rate of TBNA combined with brush biopsy forceps biopsy and pathology bronchoscopy was 84.51%,which significantly higher than the single method above(P<0.05).After comparison between the two groups,the results of comparison between forceps biopsy forceps biopsy and brushing,forceps biopsy forceps biopsy and TBNA,single method and United were all P<0.05,which was statistically significant.3.Based on the chi-square analysis results of different pathological types of P<0.05,the different detection methods have different detection rates in different pathological types of lung cancer.The chi-square analysis results of lung cancers of various pathological types showed that the positive rate of forceps biopsy forceps biopsy detection was higher than that of TBNA and brush inspection,and the detection rate of multiple pattern combinations(two combinations/three combinations)was higher than the detection rate of a single drawing method.Brushing,forceps biopsy forceps biopsy,and TBNA were compared with those obtained by combining:? squamous cell carcinoma:?2 =23.334,8.465,24.848,P<0.05;? adenocarcinoma:?2 =24.776,8.125,26.377,P<0.05;? small cell carcinoma:?2 =29.916,7.565,28.160,P<0.05;? unknown types of lung cancer:?2 =24.889,8.499,24.848,P<0.05.4.All 274 patients undergoing bronchoscopy were well tolerated.A small amount of bleeding from the puncture site was observed even under the intraoperative microscope.Bleeding can be stopped completely after sufficient irrigation and bleeding.After puncture,all patients had no obvious complications.No severe complications such as pneumothorax,massive bleeding,and mediastinal infection were found.Conclusions:1.Bronchoscopy has significant clinical application value and high safety for the diagnosis of lung cancer.2.Paying attention to the forceps biopsy forceps biopsy during the operation and combining different methods to obtain materials can significantly increase the diagnostic positive rate and avoid missed diagnosis.3.The clinical status of cTBNA cannot be shaken,and the future direction of TBNA is EBUS-TBNA.