ALA光动力荧光技术联合皮肤镜在面部区域癌化诊断中的应用  

The application of ALA photodynamic fluorescence combined with dermatoscopy in the diagnosis of facial cancerization

作　　者：夏丽晔 王为平[1] 尚智伟[1] XIA Liye;WANG Weiping;SHANG Zhiwei(First Affiliated Hospital,College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院,河南洛阳471003

出　　处：《皮肤性病诊疗学杂志》2024年第10期664-668,共5页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：河南省2023年科技攻关计划项目(232102210028)。

摘　　要：目的 探讨5-氨基戊酮酸(ALA)光动力荧光技术联合皮肤镜在面部区域癌变及癌前病变诊断中的应用价值。方法 纳入2022年3月至2024年3月河南科技大学第一附属医院皮肤科光线性角化病、BOWEN病、鳞状细胞癌、基底细胞癌患者共52例,每位患者均先后采用肉眼观察和ALA光动力荧光显影,比较两者的面积差异。对ALA光动力荧光显影区域进行8等份扇形分区,对每个扇形分区进行皮肤镜检查,判断有无癌前病变表现,并对病变面积和严重程度进行评分。结果 52例患者ALA光动力荧光显影面积均大于肉眼观察皮损面积,两组之间有显著性差异(均P<0.001)。ALA光动力荧光显影区域内皮肤镜检查均发现有不同面积和不同严重程度的癌前病变特征,其面积和严重程度评分分别为4.55±1.21、5.45±2.42、6.64±2.84、5.27±1.95。结论 ALA光动力荧光诊断联合皮肤镜检查能够发现肉眼无法察觉的区域癌前病变,为皮肤癌前病变的早期筛查和早期诊断提供了新方法。Objective To explore the application of ALA photodynamic fluorescence combined with dermatoscopy in the diagnosis of facial cancerization and precancerous lesions.Methods From March 2022 to March 2024,a total of 52 patients with actinic keratosis,BOWEN′s disease,squamous cell carcinoma and basal cell carcinoma were enrolled at the dermatology clinic of the First Affiliated Hospital of Henan University of Science and Technology.Each patient was examined by naked eye and ALA photodynamic fluorescence,and the difference in area was compared between these two methods.The ALA photodynamic fluorescence area was divided into 8 equal sections,followed by examination with a dermatoscope to determine whether there were cancerization and precancerous lesions.The lesion area and severity were scored.Results The ALA photodynamic fluorescence area was larger than that observed by the naked eye(all P<0.001).Dermatoscopic examination of the ALA photodynamic fluorescence imaging area revealed precancerous features of various areas and severity,with cancerous area and severity scores of 4.55±1.21,5.45±2.42,6.64±2.84,and 5.27±1.95,respectively.Conclusions ALA-photodynamic fluorescence combined with dermatoscopy can find cancerization and precancerous lesions that can′t be detected by naked eyes,providing a new method for early screening and early diagnosis of skin cancerization and precancerous lesions.

关 键 词：区域癌化 5-氨基戊酮酸 光动力 荧光诊断 皮肤镜 

分 类 号：R739.5[医药卫生—肿瘤]