血卟啉单甲醚激光诱发荧光光谱区分肺癌组织和正常支气管组织  

Spectroscopic differentiation between normal bronchial and lung cancer tissues by laser-induced fluorescence (LIF) with intravenous injection of hematoporphyrin monomethyl ether (HMME)

作　　者：王伟[1] 孙玉鹗[2] 周乃康[2] 李辉[1] 郑梦利[2] 李峻亨[3] 刘小兵[4] 

机构地区：[1]海军总医院胸外科,北京100037 [2]解放军总医院胸外科 [3]解放军总医院激光科 [4]解放军总医院病理科

出　　处：《中国肺癌杂志》2001年第5期360-363,共4页Chinese Journal of Lung Cancer

摘　　要：目的　探讨应用国产新型光敏剂血卟啉单甲醚 (HMME)激光诱发荧光光谱分析方法诊断肺癌的可行性。方法　 15例肺癌患者肺切除前 3小时静脉注射HMME 2 .5mg/kg ,使用三倍频YAG激光 (波长 35 5nm)和光学多道分析仪 (OMA)对切除的癌组织和正常支气管组织行激光诱发荧光光谱测定。 43个检测点均行病理检查。结果　 15例患者术后 48小时后接受阳光照射 ,无一例发生皮肤光过敏副作用。肺癌组织的荧光强度 ( 314 4 6± 5 0 17)显著低于正常支气管组织 ( 75 430± 890 8) (P <0 .0 0 1)。正常支气管组织光谱在长波区5 80～ 6 0 0nm处有一个小坪 (I580nm/I6 0 0nm =1.0 81± 0 .0 90 ) ,而肺癌组织则平滑下降 (I580nm/I6 0 0nm=1.2 6 0± 0 .15 7)。肺癌组织于 6 2 3 .4nm± 1.6nm处有一明显的特征峰 (即药物峰 )。以I580nm/I6 0 0nm比值为判据 ,诊断肺癌的敏感性、特异性和符合率分别为 80 .0 %、73 .9%和 76 .7% ;以药物峰斜率为判据 ,诊断肺癌的敏感性、特异性和诊断符合率分别为 95 .0 %、91.3 %和 93 .0 %。结论　新型光敏剂血卟啉单甲醚 (HMME)激光诱发荧光光谱能够区分肺癌和正常支气管组织 ,与激光诱发自体荧光相比 ,能够提高诊断肺癌的敏感性。Objective To study the feasibility of laser induced fluorescence (LIF) spectroscopy with intravenous injection of a new agent, hematoporphyrin monomethyl ether (HMME), in the diagnosis of lung cancer. Methods Fifteen patients with lung cancer were administrated HMME 2.5?mg/kg intravenously three hours before lobectomy. Surgical specimens were collected for examination of LIF spectrum. The LIF spectra of normal bronchial and lung cancer tissues were measured with a detecting system which consists of an YAG laser (wavelength 355 nm) and an optical multichannel analyzer (OMA). The pathological examination was performed in each specimen. Results The fluorescence intensity of the lung cancer tissues (31?446±5?017) was much lower than that of the normal bronchial tissues (75?430±8?908) (P<0.001). There was a flat spectrum in the normal bronchial tissues at the wavelength from 580 to 600 nm (I 580nm /I 600nm =1.081± 0.090 ), but the cancer tissue spectrum showed a smoothly descending profile (I 580nm /I 600nm =1.260±0.157). A remarkable characteristic peak (drug peak) located at the 623.4 nm±1.6 nm in the lung cancer spectrum. Using the criterion of I 580nm /I 600nm , the sensitivity, specificity, and accuracy of the diagnosis for lung cancer were 80.0%, 73.9%, and 76.7% , respectively, and were 95.0%, 91.3% and 93.0% respectively according to the criterion of the slope of the drug peak. Conclusion The LIF spectroscopy following intravenous injection of the new photosensitiser HMME can differentiate lung cancer from normal bronchus and can increase the sensitivity, specificity and the accuracy comparing to the laser induced auto fluorescence in the diagnosis of lung cancer. [WTHZ?

关 键 词：血卟啉单甲醚 激光诱发荧光 肺肿瘤 支气管组织 诊断方法 

分 类 号：R734.2[医药卫生—肿瘤] R443[医药卫生—临床医学]