自发荧光气管镜与白光气管镜对肺癌的诊断价值

Diagnostic values of autofluorescence bronchoscopy and white light bronchoscopy in lung cancer

目的 评价自发荧光气管镜（autofluorescence bronchoscopy,AFB）与白光气管镜（white light bronchoscopy, WLB）对肺癌的诊断价值,以及AFB与WLB对病变在白光气管镜下不同分型的诊断价值.方法 收集2007年1月～2013年12月在河北医科大学石油临床医学院同时行AFB和WLB检查,并经病理明确诊断为肺癌的患者708例,根据病理结果,比较AFB和WLB对肺癌的诊断价值以及AFB与WLB对白光镜下病变不同分型的诊断价值.结果 ①AFB与WLB对早期肺癌的检出率分别为40.0％、13.3％,差异有统计学意义（P＜0.05）.②AFB与WLB诊断肺癌的敏感度分别为95.7％、63.2％,差异有统计学意义（P＜0.05）,AFB与WLB诊断肺癌的特异度分别为89.3％、75.6％,差异有统计学意义（均P＜0.05）.③AFB与WLB诊断肺癌在白光镜下分型表现为增生、浸润、狭窄组的敏感度分别为99.0％、85.2％,97.7％、88.5％,87.3％、74.6％,差异均有统计学意义（P＜ 0.05或P＜ 0.01）.结论 AFB对肺癌的早期诊断以及肺癌在白光镜下表现为增生、浸润、狭窄时较WLB具有更大的优势.

Objective To evaluate the diagnostic values of autofluorescence bronchoscopy（AFB） and white light bronchoscopy（WLB） in lung cancer, also the values of AFB and WLB according to the macroscopic appearance of airway lesions under WLB. Methods 708 patients who were pathologically and clinically diagnosed with airway lesions and underwent both WLB and AFB were recruited and analyzed from January 2007 to December 2013 in School of Petroleum Clinical Medicine of Hebei Medical University. Results 1AFB and WLB for detecting early stage lung cancers were 40.0% and 13.3%, respectively, there was statistically significant difference（P 〈0.05）. 2The sensitivities and specificities of AFB and WLB in detecting lung cancer were 95.7% vs 63.2%, and 89.3% vs 75.6%, there were statistically significant differences（all P 〈0.05）. 3The sensitivities for AFB and WLB in detecting lung cancer among cases of proliferation, infiltration and stenosis groups were 99.0% vs 85.2%, 97.7% vs 88.5%, 87.3% vs 74.6%, there were statistically significant differences（P 〈0.05 or P 〈0.01）. Conclusion AFB shows higher superiority in diagnose of early stage lung cancer and lung cancer among cases of proliferation, infiltration and stenosis.