摘要目的 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.

abstractsObjective 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 severe atypical hyperplasia were defined as positive.Normal bronchial mucosa,mucosal hyperplasia,pachymucosa,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 cancer.Combination of WLB and AFB improved the specificity of AFB alone.