自荧光支气管镜在非小细胞肺癌气管支气管受侵T分期的应用

Application of autofluorescence bronchoscopy in tracheobronchial invasion T staging in non-small cell lung cancer

目的探讨自荧光支气管镜（AFB）在非小细胞肺癌（NSCLC）气管支气管腔受侵T分期的应用和临床价值。方法回顾性分析60例行AFB检查的NSCLC。患者常规行白光支气管镜（WLB）和AFB检查。比较WLB与AFB检查对NSCLC气管支气管腔内肿瘤边缘的判定，根据肿瘤边界黏膜活检结果，确定气管支气管腔内肿瘤受侵T分期。结果60例患者中WLB检查T分期情况：T125例，T220例，T39例，T46例。AFB检查T分期情况：T130例，T216例，T36例，T48例。病理检查T分期情况：T129例，T217例，T36例，T48例。WLB与病理检查对肺癌T分期比较：T2、T3、T4期差异有统计学意义（P〈0．05），TI期差异无统计学意义（P〉0．05）。AFB与病理检查对肺癌T分期比较，差异均无统计学意义（P值均〉0．05）。结论AFB较WLB在NSCLC分期上有一定优势，准确性更高。但由于AFB特异性稍差，在个别患者存在假阳性，因此必须结合WLB检查综合判定结果。

Objective To investigate application and clinical value of autofluorescence bronchoscopy （AFB） in tracheobronchial invasion T staging in non small cell lung cancer. Methods 60 non small cell lung cancer patients who had performed AFB were retrospectively analyzed. They all had performed white light bronehoseopy （WLB） and AFB examination. We compared WLB and AFB examination on non-small cell lung cancer tracheobronchial lumen edge determination. We determined the tracheobronchial intraluminal tumor invasion T stage according to the tumor boundary biopsy results. Results In 60 patients, Tstaging situations of WLB check：T1 （25 cases）, T2 （20 cases）, T3 （nine cases）, T4 （six cases）. T staging situations of AFB check：T1 （30 cases）, T2 （16 cases）, T3 （six cases）, T4 （eight cases）. T staging situations of pathology check：T1 （29 eases）, T2 （17 cases）, T3 （six cases）, T4 （eight cases）. There was statistical difference between WLB and pathology check in T2, T3, and T4 staging （ P 〈0.05）, and no statistical difference in T1 staging （ P 〉 0.05）. There was no statistical difference between AFB and pathology check in T staging （ P 〉 0.05）. Conclusions AFB has certain advantages and higher accuracy than WI.B in clinical staging of non small cell lung cancer, ttowever, AFB has lower specificity, we must therefore combine with WLB inspection to assess synthetically results because of false position in individual patients.