Clinical Analysis Of 92 Cases Of Peripheral Lung Cancer

Background and objective: the incidence of lung cancer is increasing year by year.Because of the location of peripheral lung cancer,it is often found that the diagnosis is not timely and the best treatment time is missed.Based on the retrospective analysis of92 patients with peripheral lung cancer treated in Department of Respiratory Medicine,Dalian Medical University,this paper discusses the incidence and dynamic changes of these patients in terms of sex,age,smoking history and so on,and evaluates bronchoscopy.The value of tumor markers in the diagnosis and classification of peripheral lung cancer.Methods:From January 1,2015 to December 1,2018,92 patients with peripheral lung cancer,confirmed by histopathology or follow up,were hospitalized in the Department of Respiratory,first affiliated Hospital of Dalian Medical University.The patientsundefined sex,age,smoking history and pathological type were collected.The basic data of pathological changes,such as the size and location of the lesions,were studied to investigate the incidence and dynamic changes in sex,age,smoking history and so on.All the patients were examined with fiberoptic bronchoscopic biopsy,and were treated with bronchofiberscope biopsy,lavage,and so on.To compare the diagnostic value of bronchoscopy and liquid-based cytology in peripheral lung cancer.Fasting venous blood was collected from all patients in the next morning and CEA,NSE,CYFRA21-1 levels were determined to explore the diagnostic and pathological value of tumor markers in peripheral lung cancer.Results: among 92 patients with peripheral lung cancer,64 were male and 28 female,the ratio of male to female was 2.29: 1.The average age was 64.9 years old,the oldest was 82 years old,the youngest was 40 years old.The incidence of peripheral lungcancer in 61-70 years old patients was the highest(40.2%).The number of smokers was58.7%(54/92),and that of non-smokers was 41.3%(38/92),of which 85%(17/20)of patients with squamous cell carcinoma and 50%(32/64)of patients with adenocarcinoma.Smoking in small cell lung cancer group accounted for 62.5%(5/8).Adenocarcinoma was the most common type,accounting for 69.6%(64/92),followed by squamous cell carcinoma(21.7%)(20/92)and small cell carcinoma(8.6%)(8/92).Results of bronchoscopy: 41 cases of lung cancer were diagnosed by lung biopsy,the positive rate was 45.00%(41/92),and 34 cases of lung cancer were diagnosed by liquid-based cytology,of which 10 cases were diagnosed only by liquid cytology,the positive rate was 37.00%(34/92).The positive rate of lung biopsy was 55.00%(51/92).There was no significant difference between the positive rate of lung biopsy and liquid-based cytology,but there was a significant difference between the combined detection and single examination.Tumor size ? 2cm in 28 cases,lung biopsy positive rate was 25.0%(6/28),lesion size 2-6cm was 46 cases,lung biopsy positive rate was52.2%(24/46).The positive rate of lung biopsy was 61.1%(11/18).The positive rate of lung biopsy increased with the increase of lesion(p<0.05).19 cases of lung cancer were located at the apex of the upper lobe or posterior segment of the tip,23 cases were located in the dorsal segment of the lower lobe,7 cases were positive for biopsy,50 cases were located in other parts of the lesion,and 29 cases were positive for biopsy.The difference of biopsy results between different sites was statistically significant.3.3.The results of tumor marker examination showed that 42 cases were positive for CEA,20 cases were positive for 41.7% of them,and 58 cases were positive for cytokeratin 19 fragment,and the sensitivity was 63.0%.The sensitivity of the combined group was the highest and the difference was statistically significant(p<0.05).CEA was the highest in adenocarcinoma,P<0.05),and the sensitivity was 76.1%(p<0.05).Compared with squamous cell carcinoma and small cell lung cancer,the expression of NSE was the highest in small cell lung cancer,significantly different from that of adenocarcinoma and squamous cell carcinoma,and the expression of cytokeratin 19 was the highest in squamous cell carcinoma.There was a significant difference compared with squamouscell carcinoma and small cell lung cancer.Conclusion:1.There was no difference between bronchoscopic biopsy and liquid-based cytology in the diagnosis of peripheral lung cancer.2.Liquid-based Cytology has a good diagnostic ability for peripheral lung cancer.3.Combined detection of multiple tumor markers can improve the diagnosis of peripheral lung cancer.