支气管镜刷检标本液基细胞学检测在肺癌诊断中的应用价值

发布时间：2018-05-23 10:24

本文选题：肺癌 + 支气管镜　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:探讨液基细胞学检查在肺癌诊断中的价值,同时分析液基细胞学联合其他取材方法对肺癌的诊断价值。方法:收集2016年10月—2017年2月期间,在本院呼吸二科住院的160例患者,分为肺癌组(A组,88例)和非肺癌组(B组,72例),均进行支气管镜检查并行钳检、LBC、CS、DNA倍体分析检查。对四种方法单独和联合检测诊断肺癌的相关指标进行比较。所有实验数据均采用SPSS 21.0统计软件进行分析。所有的统计学分析均以a=0.05为检验水准,P0.05为差异具有统计学意义。结果:1.灵敏度比较:钳检(72.73%)DNA倍体分析(71.59%)LBC(67.04%)CS(52.27%),特异度比较:钳检(100%)LBC(98.61%)CS(91.67%)DNA倍体分析(84.72%)。LBC诊断肺癌的灵敏度较CS高,差异有统计学意义(P0.05),特异度比较差异无统计学意义(P0.05)。单项检查效能分析:钳检、LBC、DNA倍体分析、CS的Kappa值分别为0.706、0.634、0.553、0.420。LBC的特异度、Youden指数、阳性预测值、阴性预测值、Kappa值、准确度均高于CS。2.LBC+钳检诊断肺癌的特异度最高为98.61%。联合检查效能分析:LBC+钳检、LBC+CS+钳检、LBC+DNA倍体分析+钳检、LBC+CS+DNA倍体分析+钳检、LBC+CS+DNA倍体分析Kappa值分别为0.789、0.725、0.709、0.708、0.673。LBC+钳检的特异度、阳性预测值、阳性似然比、准确度、Youden指数、Kappa值最高。结论:LBC检查对肺癌的诊断与组织学诊断符合高度一致性。联合检测较单项检测可以明显提高诊断肺癌的灵敏度和特异度,其中以LBC与钳检联合的总体效果最好。LBC辅助诊断肺癌的价值优于CS。
[Abstract]:Objective: to explore the value of liquid based cytology in the diagnosis of lung cancer, and to analyze the diagnostic value of liquid based cytology combined with other methods for the diagnosis of lung cancer. Methods: from October 2016 to February 2017, 160 patients were divided into lung cancer group (group A, n = 88) and non-lung cancer group (group B, n = 72). The relative indexes of four methods for the diagnosis of lung cancer were compared. All experimental data were analyzed by SPSS 21. 0 statistical software. All the statistical analysis with a0.05 as the test level for the difference was statistically significant. The result is 1: 1. Sensitivity comparison: the sensitivity of DNA ploidy analysis was 71.593.There was no significant difference in specificity (P 0.05). The sensitivity of DNA ploidy analysis in diagnosis of lung cancer was 84.720.The difference was significant (P 0.05). There was no significant difference in specificity (P 0.05). There was no significant difference in the specificity between the two groups (P 0.05). There was no significant difference (P 0.05) in the diagnosis of lung cancer by using DNA ploidy analysis (DNA ploidy analysis) (P = 94.72.LBC), and the specificity was not significantly different from that of LBC94.72.The sensitivity was higher than that of LBC94.72.The difference in specificity was not significant (P 0.05). Single test effectiveness analysis: the Kappa value of CS.2.LBC forceps was 0.706U 0.634U 0.553N 0.420.LBC, positive predictive value, negative predictive value and Kappa value were higher than that of CS.2.LBC forceps in diagnosis of lung cancer. The highest specificity of CS.2.LBC forceps in the diagnosis of lung cancer was 98.61. Analysis of DNA ploidy of LBC-CLC-clamp the DNA ploidy analysis of LBC DNA ploidy was 0.789v 0.7250.709 ~ 0.708 ~ (0.708) ~ 0.673.LBC clamp specificity, positive predictive value and positive-likelihood ratio, and the highest accuracy of DNA ploidy was found in the analysis of DNA ploidy of LBC-C and LBC-CS-V, and the accuracy of DNA ploidy analysis was higher than that of DNA ploidy (P < 0.05), and the accuracy of DNA ploidy analysis was the highest in terms of accuracy of DNA ploidy (P < 0.01). ConclusionThe diagnosis of lung cancer by WL-LBC is highly consistent with histologic diagnosis. The sensitivity and specificity of combined detection were significantly higher than that of single detection. The total effect of LBC combined with forceps examination was the best. The value of LBC assistant diagnosis of lung cancer was better than that of CSCS.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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