自体荧光支气管镜在中央型肺癌诊断中的评估价值

目的探讨自体荧光支气管镜（AFB）在早期中央型肺癌诊断中的价值。方法对161例临床怀疑为支气管肺癌患者使用AFB联合白光支气管镜（WLB）检查并进行结果分析，将病理诊断为肺癌和中．重度以上不典型增生的患者定义为阳性，正常支气管黏膜、黏膜增生、肥厚、慢性炎症定义为阴性，分析AFB与WLB镜下异常表现与病理结果。比较WLB、AFB及WLB＋AFB三种方法对支气管肺癌诊断的敏感性、特异性差异。结果WLB的敏感性、特异性分别为63．6％和77．0％；AFB的敏感性、特异性分别为96．9％和16．0％；WLB＋AFB敏感性、特异性分别为76．7％和59．4％；WLB＋AFB与WLB相比，两者敏感性差异并无统计学意义（P=0．06），而特异性差异有统计学意义（P=0．01）；WLB＋AFB与单用AFB相比，两者敏感性及特异性差异亦有统计学意义（P〈0．001）。结论AFB比WLB在肺癌诊断方面具有更好的敏感性，而联合使用WLB＋AFB则能改善单用AFB的特异性缺陷。

Clinical value of autofluorescence bronchoscopy in the diagnosis of central lung cancer

Objective To evaluate the benefit of using autofluorescence bronchoscopy （AFB） to detect early central lung cancer. Methods A total of 161 cases of suspected lung cancer were detected with AFB and white light bronchoscopy （WLB）. Pathologic diagnosis as lung cancer, and moderate and se- vere atypical hyperplasia were defined as positive. Normal bronchial mucosa, mucosal hyperplasia, pachy- mucosa, and chronic inflammation of the mucosa were defined as negative. The sensitivity and specificity of WLB, AFB, and WLB ＋ AFI imaging in the detection of lung cancer were compared to analyze the abnormal appearance of AFB and WLB. Results The sensitivity and specificity were 63.6% and 77. 0% for WLB imaging, 96.9% and 16. 0% for AFB imaging, and 76. 7% and 59.4% for combination of WLB and AFB imaging. No significant difference in the sensitivity was found between WLB and WLB ＋ AFB imaging （ P =0. 06）, but there was significant difference in the specificity between WLB and WLB ＋ AFB imaging （ P = 0. 01 ）. Significant difference in the sensitivity and specificity was found between WLB ＋ AFB and AFB imaging （ P 〈 0. 001 ）. Conclusions AFB was more sensitive than WLB in detection of centre lung canc- er. Combination of WLB and AFB improved the specificity of AFB alone.