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目的:评价正侧位胸片、CT和纤维支气管镜检查对中央型肺癌的诊断价值。方法:回顾分析85例经病理证实的中央型肺癌,全部病例均有正侧位胸片和支气管镜检查,其中40例行CT检查,对各种检查结果进行对照分析。结果:胸片、CT、纤维支气管镜对中央型肺癌的诊断符合率分别为68.2% 、85% 、89.4% ,胸片与纤维支气管镜检查结合诊断符合率达100% ,胸片和CT的影像表现对照,对肺门肿块、支气管改变及纵隔改变的显示CT明显优于X线胸片,两者差异非常显著(P< 0.01和0.001)。组织学类型以鳞癌、小细胞未分化癌多见,分别为57.6% 、32.9% 。结论:正侧位胸片是诊断中央型肺癌的基础方法,与纤维支气管镜结合可明显提高诊断符合率,CT是胸片、纤维支气管镜检查的重要补充,但不能取代前两者
Objective: To evaluate the diagnostic value of lateral chest radiograph, CT and fiberoptic bronchoscopy for central lung cancer. Methods: A total of 85 cases of pathologically confirmed central lung cancer were retrospectively analyzed. All cases had positive lateral chest radiographs and bronchoscopic examinations. Among them, 40 patients underwent CT examination. The results of various examinations were analyzed and compared. Results: The diagnostic accuracy rates of chest X-ray, CT, and fiberoptic bronchoscopy for central lung cancer were 68.2%, 85%, and 89.4%, respectively. The coincidence rate between chest radiograph and fiberoptic bronchoscopy was 100%. Images of chest X-ray and CT were obtained. In contrast, the performance of CT scans for lung masses, bronchial changes, and mediastinal changes was significantly better than that of X-ray chest radiographs (P<0.01 and 0.001). The histological types were squamous cell carcinomas and undifferentiated small cell carcinomas, which were 57.6% and 32.9%, respectively. Conclusion: Lateral chest radiograph is the basic method for the diagnosis of central lung cancer. The combination of fiberoptic bronchoscopy can significantly improve the diagnostic coincidence rate. CT is an important supplement to chest radiographs and fiberoptic bronchoscopy, but it cannot replace the former.