自发性荧光支气管镜对肺癌诊断的临床应用分析

The clinical practice and analyses of autofluorescence bronchoscopy in diagnosis of lung cancer

目的探讨自发性荧光支气管镜(autofluorescence bronchoscopy AFB)在肺癌诊断中的临床价值。方法收集252例经AFB检查的患者的临床资料进行分析。结果 (1)252例患者中共检查出肺癌114例,占45.2%;影像学有异常的234例患者中肺癌检出110例,占47%;(2)镜下荧光染色红染的198例患者中病理结果阳性者113例,占57.1%,而镜下染色为绿色的54例患只有5例为阳性;(3)病理结果为鳞癌的患者中91.2%患者其AFB镜下肉眼观为增生型,而腺癌中91.3%的表现为增生型或浸润型;(4)不同临床症状和不同影像学检查结果其病理结果经卡方检验差异无显著性(P>0.05),但男女两组以及不同镜下肉眼观的病理结果差异具有显著性意义(P<0.01)。结论 AFB检查对肺癌诊断比临床症状、影像学检查更有价值,其敏感性较强,但特异性不高。

Objective To explore the clinical value of autofluorescenee bronchoscopy in diagnosis of lung cancer. Methods The clinical data of 252 patients by AFB examination were collected and analyzed by related statistical methods. Results （ 1 ） There were 114 lung cancer in total 252 patients, accounted for 45.2% and 110 lung cancer in 234 patients with the abnormal of radiographic inspection, accounted for 47% ;（2 ）There were 113 positive results of pathology in 198 patients with the red dye of AFB, accounted for 57.1% , while only 5 positive results in 54 patients with the green dye of AFB ; （3）91.2 percent of the patients with the Pulmonary squamous cell carcino- ma showed the hyperosteogeny in the bronchoscopic intuitive of AFB, but 91.3 percent of the patients with the Lung ad showed the hyperosteogeny or infiltration;（4 ）There were no significant differences in the results of pathology, different clinical symptoms and radiographic inspection by The chi-square test （ P 〉 0. 05 ）, While there were significant differences in the sex and the bronchoscopic intuitive of AFB（ P 〈 0. 01 ）. Conclusion The AFB examination in diagnosis of lung cancer is more valuable than clinical symptoms and imaging examination, which has the stronger sensitivity, but the specificity is not high.