激光诱发荧光光谱诊断肺癌的初步临床研究

目的探讨利用激光诱发荧光（LIF）光谱对肺癌进行临床诊断的可行性。方法使用355nm的NdYAG激发光和荧光探测系统，将特制光导纤维通过纤维支气管镜的活检通道送入患者支气管，对21例患者的正常支气管壁及可疑部位进行LIF光谱测定，随后在各检测点咬取组织行病理检查。结果21例患者共测定74条曲线，经病理证实，肺癌32条，正常支气管组织42条。正常支气管组织主峰（462.4±7.5）nm、肺癌主峰（460.5±7.0）nm，两者差异无显著性意义（P＞0.05）；正常支气管组织的荧光强度为（84352±50 428），明显大于肺癌组织（33 602±19 609）差异有显著性意义（P＜0.01）；正常支气管组织在580～600nm波段表现为一小坪（I

Laser-induced fluorescence in the diagnosis of lung cancer

Objective　To explore the clinical feasibility of laser-induced fluorescence （LIF）spectroscopy in the diagnosis of lung cancer.　Methods　The LIF spectra of the normal bronchus and doubtful sites of lung cancer in 21 patients with lung cancer were measured with a detecting system consisting of an YAG laser(wave length 355 nm) and an optical multichannel analyzer(OMA). A specially made optical fibre was placed in the patient′s bronchus under a bronchoscope. The detected sites were biopsied.　Results　Seventy-four spectrum curves were detected lung cancer (32 patients) and normal bronchus confirmed by pathologically (42). The location of the principal spectral peaks of the normal bronchial tissue (462.4±7.5)nm and lung cancer（460.5±7.0)nm, showed no significant difference (P＞0.05）.　 The fluorescence intensity of the normal bronchial tissue　(84*!352±50*!428) was much higher than that of lung cancer (33*!602±19*!609)(P＜0.001). The shape of spectrum between the normal bronchial tissue and lung cancer was different at the right site of the peak. A flat spectrum was observed in the normal bronchial tissue at the wave length of 580 nm to 600 nm (I580nm/I600nm=1.064±0.133), while the cancer tissue spectrum showed a smooth descending profile (I580nm/I600nm=1.329±0.085). When the fluorescence intensity ratio of I580nm/I600nm larger or equal to 1.221 was used, the sensitivity, specificity, positive predictive value, negative predictive value and the overall accuracy of LIF spectroscopy for detection of lung cancer were 87.5%, 80.9%, 77.8%, 89.5% and 83.8%, respectively.　Conclusion　LIF spectroscopy in the clinical diagnosis of lung cancer is feasible.