电子和荧光电子支气管镜在诊断早期肺癌及癌前病变中的研究  

Application of Electron and Fluorescence Bronchoscope in the Diagnosis of Early Lung Cancer and Precancerous Lesions

作　　者：周菊兰 郑圆圆[2] 郝青林[2] 

机构地区：[1]祥云县中医医院呼吸科,云南祥云672104 [2]昆明医科大学第一附属医院呼吸内一科,云南昆明650032

出　　处：《昆明医科大学学报》2015年第3期149-152,共4页Journal of Kunming Medical University

摘　　要：目的评价电子支气管镜和荧光电子支气管镜在早期肺癌及癌前病变中的价值.方法选取昆明医科大学第一附属医院2013年1月至2014年6月经支气管镜检查且病理学明确诊断为肺癌的患者,以电子支气管镜检查52例,荧光电子支气管镜检查68例,进行统计学分析.结果 (1)白光组和荧光组两组分别检出重度不典型增生和原位癌为(4,1)例和(8,5)例,检出率分别为8.6%和20.96%,两者差异有统计学意义(P<0.05).(2)白光下58例中病理阳性为28例,病理阴性为30例,其中真阳性为18例,真阴性为22例,WLB I级14处,WLB II级3处,WLB III级11处;自荧光下62例中病理阳性为39例,病理阴性为21例,其中真阳性为35例,真阴性为13例,其中AFB I级10处,AFB II级11处,AFB III级18处.经统计分析得出白光支气管镜的敏感率为64.2%,特异率为73.3%;荧光支气管镜分别是89.7%和61.9%,两者差异有统计学意义(P<0.05),敏感性(P<0.01),特异性(P<0.01).结论电子支气管镜检查对肺癌的确诊有重要价值,荧光电子支气管镜对肺癌的早期诊断有重要意义,诊断率明显高于电子支气管镜检查.Objective To evaluate the value of electronic bronchoscopy and fluorescencebronchoscope in the diagnosis of early stage lung cancer and precancerous lesions. Methods In the study, 120 patients with lung cancer by bronchoscopy and biopsy were assigned to receive electronic bronchoscopy（n=52） or fluorescen telectronic bronchoscopy（n=68） in the First Affiliated Hospital of Kunming Medical University from January 2013 to June2014. Results（1） The white light and fluorescence detecting severe atypical hyperplasia and carcinoma in situ respectively were（4,1） and（8,5） cases and the detection rates were 8.6% and 20.96%（χ^2=2.3286,P=0.0333）.（2） The white light pathology in 58 cases were 28 cases, negative in pathology in 30 cases, of which 18 true positive, true negative in 22 cases,WLB I 14, WLB II 3, WLB III 11; self fluorescence pathology in 62 cases were 39 cases,negative in pathology in 21 cases, of which 35 true positive, true negative in 13 cases, in which AFB I 10,AFB II 11,AFB III 18. The analysis of the sensitive rate of white light bronchoscopy was 64.2%, specificity was 73.3%; fluorescence bronchoscope were 89.7% and 61.9%, the difference was statistically significant： susceptibility χ^2=13.4924, P〈0.01; specificityχ^2=6.0319, P〈0.01. Conclusions Electronic bronchoscopy has an important role in diagnosis of lung cancer. Fluorescent electronic bronchoscopy,compared with electronic bronchoscopy, provides a more accurate diagnosis rate in diagnosis of early lung cancer.

关 键 词：早期肺癌 电子支气管镜 荧光电子支气管镜 

分 类 号：R563.13[医药卫生—呼吸系统]