自发性荧光支气管镜在肺部疾病中的诊断价值

Diagnostic value of autofluorescence bronchoscopy in lung diseases

目的探讨自发性荧光支气管镜在肺部疾病中的诊断价值。方法利用Pentax SAFE-3000荧光支气管镜的普通白光支气管镜(WLB)模式和自发性荧光支气管镜(AFB)模式对我科168例以肺部占位性病变住院的患者进行检查,支气管镜下阳性病变部位行组织病理学检查,比较WLB和AFB在肺部疾病诊断中的价值。结果 168例患者中WLB异常改变128例,正常改变40例,AFB异常改变144例,正常改变24例。病理诊断肺癌97例,40例为肺部炎症、19例为肺结核、12例为肺结节病。AFB诊断肺癌的敏感度为95.88%,明显高于WLB的81.44%,差异有统计学意义(χ~2=12.071,P=0.000)。AFB诊断肺癌的特异度低于WLB,但差异无统计学意义(χ~2=2.250,P=0.134)。WLB和AFB诊断肺部炎症、肺结核及肺结节病的敏感度、特异度差异均无统计学意义(P>0.05)。结论WLB和AFB在肺部炎症、肺结核及肺结节病中的诊断价值相当,AFB诊断肺癌的敏感度高于WLB。

Objective To investigate the diagnostic value of autofluorescence bronchoscopy in lung diseases.Methods A total of 168 patients were detected by using both white light bronchoscopy（WLB） mode and autofluorescence bronchoscopy（WFB） mode of Pentax SAFE-3000 bronchoscopy.Biopsies of the positive regions were taken for pathologic examination.Results Totally 128 of 168 patients had abnormal changes in WLB mode, 144 patients had abnormal changes in AFB mode.The pathologic diagnoses for 168 biopsy specimens were as follows： bronchogenic carcinoma in 97 cases, pulmonary inflammation in 40 cases, tuberculosis in 19 cases and pulmonary sarcoidosis in 12 cases.The respective sensitivities of WLB and AFB were 81.44% and 95.88% （χ^2=12.071,P=0.000） in bronchogenic carcinoma, and the respective specificities did not show significant difference （χ^2=2.250,P=0.134）.The differences of sensitivities and specificities of WLB and AFB in pulmonary inflammation, tuberculosis, and pulmonary sarcoidosis were not statistically significant （P〉0.05）.Conclusion The value of WLB and AFB in the diagnosis of lung inflammation, tuberculosis and sarcoidosis is equivalent.The sensitivity of AFB in diagnosing lung cancer was higher than WLB.