Comparison of the Diagnostic Yield of Bronchial Brushing Cytology before and after Endobronchial Biopsy of Flexible Fiberoptic Bronchoscopy-A Prospective Study

本研究之目的在評估支氣管切片術及刷洗術連續性之適當性，以求得良好之細胞診斷率。我們藉著軟式支氣管鏡檢，探討支氣管內病灶切片前後之支氣管刷洗術取樣細胞之診斷率有何不同；並與組織切片結果做比較。結果在36個支氣管鏡檢證實有氣管內病灶患者，每一位病患皆接受切片前後支氣管刷洗術及切片術，其中29位在連續追蹤後有最終診斷；而比較其切片前支氣管刷洗術（組織切片及切片後支氣管刷洗術所得結果分別為17.2%，75.9%和79.3%；而將組織切片合併切片後細胞刷洗術其診斷率到達93.1%。因此對同一氣管內病灶，切片後支氣管刷洗術比切片前支氣管刷洗術有較高診斷率。我們的資料也支持：同時合併組織切片及切片後之支氣管刷洗術細胞學檢查，在診斷氣管內病灶有很大的幫助且減少病人複檢的麻煩和痛苦。

關鍵字

支氣管鏡檢；細胞診斷；支氣管內切片；惡性腫瘤

並列摘要

We attempt to assess the appropriate sequence of bronchial biopsy and bronchial brushing for a better cytological diagnostic yield. The fiberoptic bronchoscopy was conducted in patients with negative sputum cytology to investigate endobronchial lesions by means of pre- and post-biopsy brushing cytology. The cytological results were compared with those of biopsies. Thirty-six patients with endobronchial lesion were found by bronchoscopy, and 29 had confirmed diagnosis after follow-up. The diagnostic yields of pre-biopsy brushing cytology, bronchial biopsy and subsequent brushing cytology were 17.2 (5/29), 75.9 (22/29) and 79.3 (23/29) percentage, respectively. The overall diagnostic sensitivity of biopsy, with the addition of post-biopsy brushing cytology, approached 93.1 percent. A better diagnostic yield of post-biopsy brushing cytology could be obtained as compared to pre-biopsy brushing cytology through a fiberoptic bronchoscope for endobronchial lesions. We concluded that a higher yield of brushing cytology following biopsy might be due to the exposure of submucosal cancer cells. Our data support the notion of combined use of bronchial biopsy and subsequent brushing cytology for the diagnosis of endobronchial lesions.

並列關鍵字

bronchoscopy ； ytodiagnosis ； endobronchial biopsy ； malignancy

國際替代計量

Comparison of the Diagnostic Yield of Bronchial Brushing Cytology before and after Endobronchial Biopsy of Flexible Fiberoptic Bronchoscopy-A Prospective Study

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