NBI窄波光成像用于肺癌早期诊断的研究

目的评价窄波光(Narrow-Band Imaging,NBI)气管镜用于肺癌早期病变诊断的临床应用价值。方法 2011年2月至2013年1月我院内镜中心行气管镜检查患者87例,首先行普通白炽光气管镜检查(White light videobronchoscopy,WLB)检查结束后,转换至NIB成像检查,并对可疑病变进行活检。以活检结果作为诊断金标准评价NBI、WLB以及NBI+WLB诊断支气管黏膜病变的敏感性和特异性。结果 87例受试者中4例为浸润癌予以排除,最终83例受试者纳入分析,其中原位癌2例(2.3%),中重度不典型增生19例(21.8%),轻度不典型增生18例(14.9%);WLB诊断中重度不典型增生以上病变的敏感性为10%(95%CI:1%~30%)特异性为94%(84%~98%);NBI为81%(58%~95%)和98%(91%~100%)。结论与WLB相比NBI成像对早期肺癌黏膜下病变诊断的敏感性和特异性均较高。

Application of narrow-band imaging in the diagnosis of early lung cancer

Objective To evaluate the clinical efficacy of narrow-band imaging videobrochoscopy in the diagnosis of early lung cancer. Methods 87 consecutive subjects with suspected lung disease were included in this prospective study from Dec 2011 to Jan 2013. All of the patients underwent the white light videobronchoscopy followed by NIB videobronchoscopy and biopsied if needed. The diagnosis sensitivity and specificity of NBI videobronchoscopy,WLB and WLB plus NBI were evaluated by using the pathology as the gold standard. Results 4 cases were exclude from the study for invasive lung carcinoma,and 83 subjects were analyzed in the intention to treat analysis. There were 2 case with carcinoma in situ,19 cases with moderate to severe dysplasia and 18 patients with mild dysplasia. The sensitivity and specificity for WLB and NBI were 10%（ 95% CI： 1% ～ 30%） and 94%（ 84% ～98%）,81%（ 58% ～ 95%） and 98%（ 91% ～ 100%） respectively. Conclusion Compared with WLB,NBI has a higher sensitivity and specificity in the diagnosis of early lung carcinoma.