专题笔谈
ENGLISH ABSTRACT
弥漫性实质性肺疾病外科肺活检疾病谱变化带来的思考
冯瑞娥
作者及单位信息
·
DOI: 10.3760/cma.j.cn112147-20211121-00822
Commentary on “Diagnostic value of surgical lung biopsies for diffuse parenchymal lung disease: the change of disease spectrum in the past 28 years in a single institution in China”
Feng Ruie
Authors Info & Affiliations
Feng Ruie
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
·
DOI: 10.3760/cma.j.cn112147-20211121-00822
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摘要

30年来,我国的弥漫性间质性肺疾病(DPLD)的诊断取得了长足的进步,对疾病的认识显著提高,越来越多的疾病结合临床、实验室检查及典型HRCT得以诊断。同时,多学科讨论诊断模式开展,提高了诊断率,外科肺活检数量呈下降趋势。一些DPLD疾病仍然需要肺活检,不同疾病要求肺活检方式不同,一些有特征性病理特点的疾病可以经小活检标本诊断,临床影像不典型及复杂疾病仍然需要外科肺活检。冷冻肺活检比传统经支气管镜肺活检有更高诊断率。我国总体DPLD肺活检偏低,非肿瘤专科呼吸病理发展相对滞后,临床仍然存在激素经验性治疗的现象,其诊断及规范治疗都存在诸多问题,需要不断努力。

ABSTRACT

In the past 30 years, the diagnosis of diffuse interstitial lung disease (DPLD) in China has made great progress,and the understanding of the disease has been significantly improved. More and more diseases have been diagnosed by combining clinical, laboratory examination and typical high-resolution computed tomography(HRCT). In addition, the application of multidisciplinary discussion increased diagnosis rate, and the number of surgical lung biopsies was on a decreasing trend. However, lung biopsy was still required for some DPLD diseases. Different diseases required different lung biopsy methods. Some diseases with characteristic pathological features can be diagnosed by small biopsy specimens. Transbronchial cryobiopsy has a higher diagnostic rate than traditional bronchoscopic lung biopsy. Overall, the number of lung biopsy for DPLD is relatively low in China, and the development of non-tumor respiratory pathology is relatively lagging behind, and there is still the phenomenon of empirical hormone therapy in clinic. So many aspects on diagnosis and standardized treatment of DPLD still require continuous efforts to improve in the future.

Feng Ruie, Email: mocdef.3ab611eiurgnef
引用本文

冯瑞娥. 弥漫性实质性肺疾病外科肺活检疾病谱变化带来的思考[J]. 中华结核和呼吸杂志,2022,45(03):247-249.

DOI:10.3760/cma.j.cn112147-20211121-00822

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*以上评分为匿名评价
本期论著栏目发表了我院呼吸科团队彭敏等 1撰写的《外科肺活检在诊断弥漫性实质性肺疾病中的价值:单中心28年来疾病谱变化》一文,总结了我院近30年因弥漫性实质性肺疾病(DPLD)行外科肺活检的455例患者的疾病谱及分布变化,客观分析了这些变化可能的深层次原因,数据耐人寻味,部分反映出了业内对间质性肺疾病的认识历程,折射出30年来间质性肺疾病的认识及诊断水平得到了显著提高,令人欣喜。该研究为单中心数据,且只分析了外科肺活检部分,有其局限性,而作为论著只能就相关数据讨论,有些问题并不能覆盖到。各位读者可能和我一样,难免会联想到关于间质性肺疾病相关的一些其他问题,下面就文章未尽的一些问题谈谈自己粗浅的看法。
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参考文献
[1]
彭敏,许文兵,徐作军,. 外科肺活检在诊断弥漫性肺实质疾病中的价值: 单中心28年来疾病谱变化[J]. 中华结核和呼吸杂志, 2022,45(3):255-260. DOI: 10.3760/cma.j.cn112147-20211012-00712 .
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American Thoracic Society,European Respiratory Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001[J]. Am J Respir Crit Care Med, 2002,165(2):277-304. DOI: 10.1164/ajrccm.165.2.ats01 .
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冯瑞娥,Email: mocdef.3ab611eiurgnef
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冯瑞娥. 弥漫性实质性肺疾病外科肺活检疾病谱变化带来的思考[J]. 中华结核和呼吸杂志, 2022, 45(3): 247-249. DOI: 10.3760/cma.j.cn112147-20211121-00822.

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