激光荧光光谱诊断上消化道癌的研究

Application of Laser Fluorescence Spectrum in Diagnosis of Upper Gastrointestinal Cancers

本文报告上消化道癌荧光光谱诊断的结果。荧光激发光源为氩离子激光器,光敏剂采用HpD,光谱分析用JAZD—Ⅱ型激光荧光分光计。受检者于检测日前72小时静脉注射HpD,剂量5mg/kg。检测日空腹做内镜检查,从内镜活检腔导入激光,与荧光分光计连接,由监视器显示谱图并记录。本组40例,男性35例,女性5例。食管癌13例、贲门癌17例、胃癌4例、吻合口异型增生3例、炎症3例。34例确诊恶性肿瘤者谱图阳性33例(97.1％),异型增生3例均阳性,炎症均阴性,无假阳性者。肉眼荧光观测阳性率低于谱图(91.2％)。荧光光谱图显示的癌灶直径最小者1cm,最大者10cm。

A study on clinical application of laser fluorescence spectrum in diagnosis of upper gastrointestinal cancers has been carried out. The excitation light source was an argon ion laser. The photosensitizer hematoporphyrin derivative (HpD, Beijing Institute of Pharmaceutic Industry) was given IV in a dose of 5 mg/kg, 72 hours prior to fluorescence examination. The light beam was delivered through the biopsy channel of the endoscope, connected with the spectrometer. A JAZD—Ⅱ laser fluorospectrophotometer was used as a spectrum analyzer. The spectrum was shown on the monitor and recorded by a computer. There were 40 patients in the study group, including 35 males and 5 females. Among them 13 patients had esophageal cancer, 17 cardiac cancer, 4 gastric cancer, 3 with dysplasia at anastomotic stoma, while other 3 with inflammatory lesions at anastomotic stoma. Among the 34 patients with malignant tumors, 33 cases showed positive reaction on fluorescence spectrum (97.1%). All the 3 cases with dysplasia also showed positive reaction on spectrum examination. The 3 patients with inflammatory lesions showed negative result. The negative false rate of malignant tumor diagnosis was 2,9%. No false positive case occurred in this group. The positive rate by gross inspection was lower (91.2%) The smallest cancer detected by fluorescence spectrum was 1 cm and the Iargest 10 cm in diameter.