窄带成像联合自荧光支气管镜对中央型肺癌的诊断价值

Combination of narrow band imaging （NBI） and autofluorescence bronchoscopy （ AFB ） in the assessment of central lung cancer

目的评估窄带成像技术（NBI）对中央型肺癌的诊断价值。方法对153例高度怀疑中央型肺癌的病例先进行白光支气管镜（WLB）检查，再使用NBI、自荧光支气管镜（AFB）检查，在每例镜下观察到的异常黏膜部位取3块或以上的组织送检。比较NBI、AFB、NBI联合AFB三种方法的敏感度和特异度。结果153例接受支气管镜检查的患者中，男106例，女47例。NBI镜下阳性91例，阴性62例，NBI的敏感度和特异度分别为63．5％（87／137）和75．O％（12／16）；AFB镜下阳性140例，阴性13例，AFB的敏感度和特异度分别为94．2％（129／137）和3I．3％（5／16）；NBI联合AFB镜下阳性133例，阴性20例，其敏感度和特异度分别为95．6％（131／137）和87．5％（14／16）。NBI联合AFB与单用AFB的特异度比较差异有统计学意义（P〈0．01），而敏感度比较差异无统计学意义（P〉0．05）。NBI联合AFB与单用NBI的敏感度比较差异有统计学意义（P〈0．01），而两者特异度均处于临界水平。结论NBI联合AFB检查可弥补AFB特异度低的不足。

Objective To assess the diagnostic value of narrow-band imaging （NBI） in the diagnosis of central lung cancer. Methods Patients （ n = 153 ） suspected of having lung cancer underwent white light bronchoscopy（WLB） , NBI and autofluorescence bronchoscopy（AFB） in turn. At least 3 biopsies in each case were taken from sites visualized as lesions. The sensitivity and specificity of NBI, AFB and combination of NBI and AFB were compared. Results There were 106 male （69. 3% ） and 47 female patients （30. 7% ）. By NBI, 91 and 62 cases were positive and negative respectively. The sensitivity and specificity of NBI were 63.5% （87/137） and 75.0% （12/16） respectively. By AFB, 140 and 13 cases were positive and negative respectively. The sensitivity and specificity of AFB were 94. 2% （129/137） and 87.5% （5/16） respectively. By NBI combined with AFB, 133 and 20 cases were positive and negative respectively, the sensitivity and specificity being 95.6% （131/137） and 87.5% （14/16） respectively. The difference of specificity between NBI plus AFB and AFB alone was significant （ P 〈 0. 01 ） , but the difference of sensitivity between NBI plus AFB and AFB alone （ P 〉 0. 05 ） was not. The difference of specificity between NBI plus AFB and NBI alone was significant （P 〈 O. 01 ）, but the P value of specificity between NBI plus AFB and NBI was 0. 03. Conclusion Combination of NBI and AFB could increase the specificity of lung cancer diagnosis compared to AFB alone.