自荧光支气管镜用于非小细胞肺癌手术评估的临床观察

Clinical evaluation of non small-cell luny cancer operated by autofluorescence bronchoscopy

目的 探讨自荧光支气管镜在肺癌手术评估中的作用及对手术方式选择的意义。方法 回顾性分析32例行手术治疗的非小细胞肺癌（NSCLC）患者资料。患者术前常规行普通白光支气管镜（WLB）和自荧光支气管镜（AFB）检查。比较WLB与AFB检查肿瘤侵犯黏膜情况,根据黏膜活检结果,判定肿瘤生长边界,从而决定手术方式。结果 32例手术患者中19例行肺叶切除术,1例行气管隆突重建术,8例行袖状肺叶切除术,4例因发生气管内转移而选择其他治疗。8例行袖状肺叶切除术的患者中3例为WLB和AFB共同发现,5例为AFB单独发现。4例无法手术患者中2例为WLB和AFB共同发现,2例为AFB单独发现。AFB对支气管黏膜癌变敏感性显著高于WLB（P＜0.05）。结论 AFB是一种安全高效的检查方法,与WLB相比能显著提高肺癌检查的敏感性,对手术方式的选择具有重要意义。

Objective To explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.Methods To retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy（WLB） and autofluorescence bronchoscopy（AFB） had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.Results In 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 cases were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremely higher with the addition of AFB than WLB alone（P＜0.05）.Conclusion Autofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.