关键词: 癌,非小细胞肺, 支气管镜检查, 疾病特征

Abstract:

Objective: To analyze the pathological types and imaging characteristics of lung cancer under electronic bronchoscopy and its diagnostic value. Methods: A retrospective analysis was conducted to collect the clinical data of 213 patients who underwent electronic bronchoscopy in the Endoscopy Center of Wuhan Pulmonary Hospital from July 2020 to June 2022. Gender, age, microscopic lesion characteristics and location, number of biopsy forceps samples and pathological type of lung cancer were analyzed. Results: All of 213 cases of lung cancer, 108 cases (50.7%) had squamous cell carcinoma, 51 cases (23.9%) had lung adenocarcinoma, 24 cases (11.3%) had lung small cell carcinoma, and 30 cases (14.1%) had malignant tumor of other types or could not be clearly classified, among them 2 male patients had lung squamous cell carcinoma complicated with lung small cell carcinoma. Among the 213 cases of lung cancer, the majority of them were male (85.4%, 182/213). Squamous cell carcinoma was mostly found in male (98.1%, 106/108) and adenocarcinoma in female (64.5%, 20/31), there was a significant difference of pathological types between the two genders (χ²=48.293, P=0.000). The most frequent sites of the lesions were: right branch (59.2%, 126 cases) >left branch (42.7%, 91 cases) >main trachea (16.9%, 36 cases). The squamous cell carcinoma was mainly hyperplastic (66.7%, 72/108), showing as new organism grew into the lumen under microscope, often accompanied by erosion, ulcer or white necrosis (36.1%, 39/108); 58.8% (30/51) of adenocarcinoma and 70.8% (17/24) of small cell carcinoma were found to be infiltrated under microscope. There were 41.2% (21/51) of adenocarcinoma and 87.5% (21/24) of small cell carcinoma getting lesions with vascular abnormalities, such as dense, thickened, disordered and tortuous vessels. There was a significant difference in the microscopic manifestations of different pathological types of lung cancer (χ²=31.113, P=0.000). 62.0% (132/213) patients with lung cancer required 3 pieces or less biopsy tissues for pathological diagnosis,and only 6.6% (14/213) of lung cancer patients needed more than 6 pieces. Conclusion: Bronchoscopy could directly observe the lesion and its imaging manifestations which could be of help to determine the pathological type of lung cancer, also could directly take the biopsy tissue for pathological diagnosis. Therefore, it is an important way to detect and diagnose lung cancer.

Key words: Carcinoma, non-small-cell lung, Bronchoscopy, Disease attributes