| Background:Lung cancer is one of common malignant tumors of the world, the morbidity and mortality rates showed an upward trend in many states since1950s'. The prognosis of lung cancer is closely related to the implementation of early effective interventions. Bronchoscopy, as a minimally invasive method of diagnosis and differential diagnosis of respiratory disease, whose development made increasing lung cancer diagnosed in early stage. Particularly, it can identify the organization type and the degree of differentiation of the most of lung cancer, which provided a timely and reliable basis for the clinical treatment. Currently, transbronchial lung biospy(TBLB) and transbronchial lung brushing cytology is still the main bronchoscopic method in Clinical, which can diagnose 90% of lung cancer occurring the bronchia above 3-4 level. As for the peripheral lung cancer occurring the bronchia below 3-4 level, whose endoscopic features are widespread inflammatory of bronchial mucous or approximately normal performance, transbronchial lung biospy and transbronchial lung brushing cytology have a obviously low diagnostic sensitivity because most of the pathological changes are not in the bronchoscopic visible scope. B AL is a new bronchoscopic technique for the diagnosing and treating of pulmonary disease, which is a method to get the cell component and the soluble material of pulmonary by injecting the physiological saline and collecting the pulmonary alveolus surface fluid. It is mainly used for the diagnosis and treating of related pulmonary disease, as well as the studying of cause of disease, pathogenesis, treatment, prognosis and so on. Improving the rate of collecting the positive cells is hoped to improve the diagnostic sensitivity of peripheral lung cancer.Objective:To discuss the value of IBAL in the diagnosis and classification of lung cancer.Methods:①To recall the 38 cases which have been check by traditional broncho-alveolar lavage(TBAL) of our hospital from March 2009 to January 2010 and the 139 cases which have been checked by bronchoscopy from March 2010 to January 2011, and all the cases have been diagnosed with lung cancer by biopsy. For the 38 cases which have been checked by TBAL,26 cases were male,12 cases of women, average (57.53±2.46) years old, the sensitivity is 47.37%(18/38), the accuracy of classifying is 36.84%(14/38); For the 49 cases which have been checked by IBAL,33 cases were male,16 cases of women, average (60.20±1.69) years old, the sensitivity is 69.39%(34/49), the accuracy of classifying is 63.27%(31/49); For the 108 cases which have been checked by TBLB,75 cases were male, 33 cases of women, average(57.04±2.14) years old, the sensitivity is (96/108) 88.89%, the accuracy of classifying is (84/108) 77.78%;②To summary the 83 cases from the whole 139case whose endoscopic features were widespread inflammatory of bronchial mucous or approximately normal performance, including 56 cases which have been checked by TBLB, 35 cases were male,21 cases of women, average(57.21±2.75) years old, the sensitivity is (45/56) 80.36%, the accuracy of classifying is (39/56) 69.64%; 37 cases which have been checked by IBAL,22 cases were male,15 cases of women, average (59.88±2.04) years old, the sensitivity is 72.97%(27/37), the accuracy of classifying is 67.57%(25/37); Before the pairwise comparison of these groups, the age and the sex pass through statistics to be quite even not remarkable difference(P>0.05).Results:(1)IBAL is more sensitive and has a higher accuracy of classifying than TBAL, and the difference has statistic significance (P<0.05); (2)In the group of whole 139 cases, TBLB is more sensitive than IBAL, the difference have statistic significance (P<0.05); But the difference of accuracy of classifying has no remarkable difference; (3)In the group of 83 cases which the endoscopic features were widespread inflammatory of bronchial mucous or approximately normal performance, the sensitivity and the accuracy of classifying pass through statistics to be quite even not remarkable difference(P>0.05) between the cases of checked by TBLB and the cases of checked by IBAL.Conclusions:①IBAL is more sensitive than TBAL in the diagnosis of lung cancer, and has a higher value in the classification of tissue.②TBLB is more sensitive than IBAL in the diagnosis of whole lung cancer, but the accuracy of classifying pass through statistics to be not remarkable difference.③For peripheral lung cancer with the endoscopic features that widespread inflammatory of bronchial mucous or approximately normal performance, the sensitivity and the accuracy of classifying pass through statistics to be not remarkable difference(P>0.05) between TBLB and IBAL...
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