大肠癌体内激光诱发荧光光谱分析  

Laser-induced fluorescence (LIF) spectrum of colorectal cancer in vivo

作　　者：李静[1] 李世荣[2] 高革[2] 曹建彪[2] 李雅君[2] 李世拥[2] 于波[2] 田玉旺[2] 

机构地区：[1]空军总医院内五科,北京100036 [2]北京军区总医院

出　　处：《中华肿瘤杂志》2000年第5期398-400,共3页Chinese Journal of Oncology

基　　金：军队九五科研资助项目(96B006)

摘　　要：目的　研究体内大肠癌、腺瘤性息肉、慢性炎症与正常组织的激光诱发荧光 (LIF)光谱 ,重点探讨癌前病变的特征性光谱规律。方法　将与氮分子激光器 (激发波长 337nm)耦合的光纤经纤维结肠镜活检孔插入 ,激光由光纤导入 ,分别检测 83例患者体内病变组织 (包括大肠癌 39例 ,腺瘤性息肉 33例 ,慢性炎症 2 3例 )与正常组织的LIF光谱 ,所得光谱由同根光纤导出 ,由OMAⅢ进行记录、分析处理。结果　癌与正常组织的光谱强度及形态存在差异 :①正常组织的光谱强度明显高于癌组织。②癌组织的主峰波长较正常组织向红光侧移动。③癌组织的次峰下降较正常组织缓慢。根据以上特点 ,选择主峰强度 (x1)、Ⅰ 40 0nm/Ⅰ 5 30nm(x2 )和集成荧光强度 (35 0nm～ 6 0 0nm) (x3)等 3个参数求得判别方程 ,诊断大肠癌的敏感性和特异性分别为 83.3%和 94.4% ,伴有中 重度不典型增生腺瘤性息肉 87.1%判别为异常。结论　LIF光谱可以在体内将大肠癌组织与正常组织区别开来 ,尤其是对不典型增生的鉴别能力较强 ,提示LIF对于大肠癌的早期诊断有非常重要的意义。Objective To study the LIF spectrum of colorectal cancer, adenomas, chronic colitis and normal colon tissue in vivo, with special emphasis on precancerous lesions.Methods A nitrogen laser (wave length 337 nm) beam was introduced through endoscopic colonoscope and the fluorescence emission was recorded. An optical multichannel analyzer (OMA Ⅲ) was used to analyze the fluorescence emission spectrum. A total of 83 patients was exanmined.Results The emission spectrum of LIF recorded on colorectal cancer and normal tissue showed significant differences in intensity and shape. (1) The normal tissue had higher intensity than that of cancer tissue. (2) The main peak wavelength of cancer moved to the red. (3) The minor peak of the cancer tissue fell more slowly than that of the normal tissue. Intensity of the main peak (x1), intensity ratio of 400 to 530 nm (x2) and the integrated LIF intensity (350～600 nm) (x3) were used as parameters to obtain an equation. The sensitivity and specificity of LIF for diagnosis of colorectal cancer was 83.3% and 94.4%, respectively. In 87.1% of moderate and severe dysplastic adenomatous polyps, the fluorescence spectrum was abnormal.Conclusion In vivo, the LIF spectrum can be used to distinguish colorectal cancer from normal colon, especially from dysplasia. It plays an important role in the early diagnosis of colorectal cancer.

关 键 词：结直肠肿瘤/诊断 激光诱发荧光 光谱分析 

分 类 号：R735.340.4[医药卫生—肿瘤]