自发荧光支气管镜在肺癌早期诊断中的应用

目的探讨自发荧光支气管镜(AFB)检查在肺癌早期诊断中的应用价值。方法 297例肺癌患者,其中行AFB检查并经病理检查确诊者96例,行普通电子支气管镜检查并经病理检查确诊者201例,比较AFB与普通电子支气管镜检查对肺癌的诊断价值。结果中央型肺癌以鳞癌最多见,其次是腺癌、小细胞肺癌。鳞癌、小细胞肺癌以增生型表现为主,腺癌以增生型及浸润型表现为主。AFB活体组织检查肺癌确诊率与普通电子支气管镜比较差异无统计学意义(P>0.05);AFB刷片细胞学检查肺癌确诊率显著高于普通电子支气管镜(P<0.05)。AFB下增生型肺癌活体组织检查和刷片细胞学检查确诊率显著高于浸润型(P<0.05)。AFB下增生型肺癌活体组织检查确诊率与普通电子支气管镜比较差异无统计学意义(P<0.05),AFB下增生型肺癌刷片细胞学检查确诊率显著高于普通电子支气管镜;AFB下浸润型肺癌活体组织检查和刷片细胞学检查确诊率与普通电子支气管镜比较差异均无统计学意义(P>0.05);AFB下间接征象活体组织检查和刷片细胞学检查肺癌确诊率与普通电子支气管镜比较差异均无统计学意义(P>0.05)。结论AFB检查可以通过荧光染色明确病变部位、范围,提高镜检阳性率,是肺癌早期诊断的重要手段之一。

Autofluorescence bronchoscopy for diagnosing early lung cancer

Objective To investigate the value of autofluorescence bronchoscopy(AFB)examine in the early diagnosis of lung cancer.Methods Among 297 patients with lung cancer,96 cases were diagnosed by AFB and pathological examination,201 cases were diagnosed by common electronic bronchoscopy(CEB)and pathological examination.The value of AFB and CEB for diagnosing lung cancer was compared.Results Most of central lung cancers were squamous carcinoma,followed by adenocarcinoma and small cell lung cancer.The growth characteristics of most squamous carcinoma and small cell lung cancer were hyperplasia,and the growth characteristics of most adenocarcinoma was hyperplasia and soakage.There was no significant difference in the biopsy diagnosis rate of lung cancer between AFB and CEB(P>0.05),but the brush cytology diagnosis rate of lung cancer by AFB was significantly higher than that by CEB(P<0.05).The biopsy and brush cytology diagnosis rates of hyperplastic lung cancer by AFB were significantly higher than that of infiltrative lung cancer(P<0.05).There was no significant difference in the biopsy diagnosis rate of hyperplastic lung cancer between AFB and CEB(P>0.05),but the brush cytology diagnosis rate of hyperplastic lung cancer by AFB was significantly higher than that by CEB(P<0.05).There was no significant difference in the biopsy and brush cytology diagnosis rates of infiltrative lung cancer between AFB and CEB(P>0.05).There was no significant difference in the biopsy and brush cytology diagnosis rates of lung cancer with indirect sign between AFB and CEB(P>0.05).Conclusion AFB can discover and determine the diseased region and range by fluorescein stain,and improve the positive diagnosis rate of lung cancer.It is an important means of early diagnosis of lung cancer.