气管镜窄带成像与光镜检查对肺癌检出率的对比

A study of different detection rate of lung cancer by bronchoscopy between narrow-band imaging and white light

目的探讨气管镜窄带成像（NBI）下与光镜下对中央型肺癌检出率的差异，进一步分析NBI下不同类型肺癌的影像学特点与差异。方法前瞻性分析该院在2010年7月-2012年3月确诊中央型肺癌患者47例。入组患者均依次经过气管镜普通光镜模式及NBI模式检查，并分别在可疑病变处靶向取活检行病理检查。结果气管镜单独普通光镜下活检确诊中央型肺癌37例（78-7％），气管镜单独NBI下活检确诊中央型肺癌43例（91．5％），两者检出率差异无显著性（p〉0．05），但气管镜普通光镜联合NBI检出率为45例（95．7％），与单独光镜下的检出率差异有显著性（P〈0．05）。另外，在NBI模式下确诊腺癌的26名患者当中，NBI影像学改变显示轻度改变的4例（15．4％），中度改变的4例（15．4％），重度改变的18例（69．2％）；而NBI模式下确诊其他类型肺癌的17名患者当中，NBI影像学改变显示轻度改变的9例（52．9％），中度改变的5例（29．4％），重度改变的4例（23．5％）。对比气管镜NBI模式下腺癌与非腺癌的影像学异常程度差异有显著性（P〈0．05）。结论气管镜光镜联合NBI下对肺癌活检的检出率较单独光镜下的检出率增高，其中肺腺癌较非腺癌NBI影像学异常程度更明显。

[ Objective ] To study the difference of Detection Rate in central Lung Cancer by bronchoscopy between narrow-band imaging （NBI） and white light, Further learning the characteristics and differences about imaging in various types of lung cancers under NBI. [Methods] 47 patients from Jul, 2010 to Mar, 2012 were prespectively analyzed, who were diagnosed with central lung cancer in our hospital. All these patients were performed bron- choscopy under white light （WL） and NBI, and were aimed to take a biopsy for pathological examination at the suspicious lesion. [Results] 37 cases of biopsy were diagnosed lung cancer under WL bronchoscopy, while 43 cases under NBI bronchoscopy. 45 cases under WL combined with NBI bronchoscopy. The diagnosis rates between both method were not significant different, but there were significant difference between WL combined NBI with WL alone. In addition, among 26 patients with confirmed adenocarcinoma under NBI, there were 4 cases images had mild change, 4 cases for moderate change and 18 cases for severe changes respectively. However, among 17 patients, diagnosed with other types of lung cancer under NBI, the number of people with mild change, moderate change and severe change were 9, 5, and 4, respectively. Significant differences exist in the abnormality of images between adenocarcinoma and non-adenocareinoma under NBI mode. [ Conclusions ] The lung cancer detection rate was significantly higher under WL combined NBI bronchoscopy than WL alone bronchoscopy. Under NBI, degree of abnormality was even more obvious in adenocarcinoma than in non-adenocarcinoma.