白光支气管镜联合荧光支气管镜对支气管腔内肺癌的诊断价值

Combination of white light bronchoscopy with autoflorescence imaging videobronchoscopy in the diagnosis of lung cancer

目的 探讨常规白光支气管镜（WLB）联合荧光支气管镜（AFI）技术对中央型支气管肺癌的诊断价值.方法 对23例普通WLB下支气管腔内黏膜病变怀疑肺癌的患者进行AFI检查,并用活检钳进行活检,病理学诊断由我院病理科进行.结果 23例患者均获得明确病理学诊断结果.16例AFI荧光阳性的患者中,诊断肺癌14例,良性病变2例;7例AFI阴性患者中良性病变6例,肺癌1例.普通WLB联合AFI诊断支气管腔内肺癌的敏感性为93.3％,特异性为75.0％,诊断准确率达87.0％,阳性预测值87.5％,阴性预测值85.7％.结论 WLB联合AFI技术可以提高支气管腔内肺癌的诊断准确性,在肺癌的诊断中具有很高的应用价值.

Objective To evaluate the accuracy of combination of white light bronchoscopy （WLB） with autofiuorescence imaging videobronchoscopy （AFI） in the diagnosis of endobronchial lung cancer. Methods From Aug. 2012 to Jan. 2013,we did AFI videobronchoscopy in 23 patients who were suspected of endobronchial lung caner by WLB. All the patients were biopsied with forceps under the guid- ance of AFI. The pathological examination was conducted by the pathologists of the same hospital. Results All 23 cases were definitely diagnosed with pathological results. Of 16 patients that were positive for au- tofiuorescence, 14 were diagnosed as lung cancer and 2 were benign diseases. Of 7 patients that were nega- tive for autofluorescence ,6 were diagnosed as benign diseases and only 1 patient was diagnosed as lung cancer. The sensitivity and specificity of combination of WLB with AFI for endobrouchial cancer was 93.3% and 75.0% respectively,and the diagnostic accuracy was 87.0%. The positive and negative pre- dictive value was 87.5% and 85.7% respectively. Conclusion Our results showed that combination of WLB and AFI is helpful in increasing the diagnostic accuracy of endobronchial lung cancer. In conclusion, AFI has critical role in the diagnosis of lung cancer.