激光诱发大肠恶性肿瘤自体荧光光谱分析

Analysis of laserinduced fluorescence spectra of colorectal malignant tumor specimens

目的激光诱发荧光（ＬＩＦ）技术与大肠镜检查结合起来，可实时区分恶性肿瘤和非恶性肿瘤组织，准确引导活检。方法对６２例大肠肿瘤标本的ＬＩＦ光谱进行分析。结果５６例标本恶性肿瘤主、次峰及波谷峰强度明显低于对照组织，其瘤／对照峰强度比值分别为１∶３．３６、１∶５．２２和１∶５．９４（Ｐ＜０．０５）；与非恶性肿瘤组织比较，恶性肿瘤组织主峰波长略偏红光侧，次峰略偏紫光侧，主、次峰间的波变化速率相对较缓；６例未表现出上述特点，１例为腺瘤样增生，２例结肠癌细胞间有大量纤维组织，另３例原因不能确定，推测可能与粘膜下结构有关。ＬＩＦ诊断大肠恶性肿瘤，敏感度为９０．３％，特异度为１００％，阳性预示值９８．２％，阴性预示值８３．３％，准确度为９１．９％。结论ＬＩＦ引导内镜活检是可行的，应有良好前景。

Objective Laserinduced fluoresence(LIF) has been known of the ablility to distinguish neoplastic from nonneoplastic tissue.This study was attempted to combine this technique with colonoscopy to see if the combination would be capable of making a real time diagnosis of colon cancer and a guide for biopsy of early malignancy. Methods 62 sugically removed specimens of colon cancer with surrounding nonneoplastic tissues were detected by LIF. Results 90 percent of the specimens showed that 1.the intensities of first and second wave peaks and the trough in tissue with tumor decreased significantly (P<0.05) than those in tissue without tumor, associated with a ratio(neoplastic versus nonneoplastic)of 13.36, 15.22 and 15.94 respectively;2.the wave length of first peak in cancer shifted slightly to the red side and that of second peak moved a little to the violet side;3.the wave form in cancerous specimen showed lighter slopes than that of normal,6 out of 62 specimens failed to show above features due to uncertain causes.The sensitivity,specificity,positive and negative predictive values as well as the accuracy of this combination attained 90.3,100,98.2,83.3 and 91.9 precent respectively. Conclusion The combined use of LIF and colonoscopy is of prospect to detect early cancer.