自荧光支气管镜在非小细胞肺癌术前评估中的应用  

Application of autofluorescence bronchoscopy during the process of preoperative evaluation of non- small cell lung cancer

作　　者：程剑剑[1] 王盛超[2] 何苡[3] 胡为才[3] 李玉光[1] 马利军[1] 

机构地区：[1]河南省人民医院呼吸科,郑州450003 [2]河南科技大学第一附属医院胸外科 [3]河南省人民医院胸外科,郑州450003

出　　处：《中华实验外科杂志》2011年第6期993-995,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨自荧光支气管镜（AFB）在非小细胞肺癌（NSCLC）患者术前评估中的应用价值。方法将254例患者随机分为白光支气管镜（WLB）检查组和AFB检查组，比较两组手术患者的切缘癌细胞阳性率、切缘不典型增生阳性率，和两组术后患者的复发率及生存率。结果AFB组NSCLC术后切缘癌细胞阳性率（1．9％）及不典型增生阳性率（3．8％），显著低于WLB组（5．7％、23．8％）（χ^2=21．755，P〈0．05），AFB组术后局部复发率（10．4％）显著低于WLB组（38．5％）（χ^2=23．692，P〈0．05），1、2、3年生存率AFB组分别为91．5％、78．3％、63．2％显著高于WLB组69．7％、48．4％、33．6％（χ^2=16．815、14．167、13．413，P〈0．05）。结论AFB有助于识别NSCLC并确定其边界，为手术治疗提供可靠依据，降低术后患者局部复发率，提高患者生存率，在NSCLC患者术前评估中有重要意义。Objective To evaluate the applied value of autofluorescence bronchoscopy （AFB） during the process of the preoperative evaluation of non-small cell lung cancer. Methods 254 patients were classified randomly into white light bronchoscopy （WLB） inspection group and AFB inspection group. The positive incisal edge rate of the cancer cells, the positive incisal edge rate of atypical hyperplasia, local recurrence rate and survival rate were compared. Results The positive incisal edge rate （ 1.9% ） and atypical hyperplasia rate （ 3.8% ） in AFB inspection group were significantly lower than in WLB group （5.7%, 23.8% ,χ^2 =21. 755, P 〈0. 05）. The local recurrence rate in AFB inspection group （10.4%） was significantly lower than WLB group （38. 5% ,χ^2 =23. 692, P 〈0. 05）. One-, 2- and 3-year survival rate in AFB group （91.5% , 78.3%, and 63.2% ） was significantly higher than in WLB group （69. 7%, 48.4%, 33.6% ,χ^2 =16. 815, 14. 167, 13.413, P〈0.05）. Conclusion AFB is important during the process of preoperative evaluation of non-small cell lung cancer. It can find the frequent bronchus submucosa transferring of lung cancer and ensure its edge. It can provide the reliable basis for the surgical operation, reduce the local recurrence rate and increase the survival rate.

关 键 词：支气管镜 自荧光 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]