胃液固有荧光光谱对胃癌筛查应用价值的研究  

Study on autofluoresecence spectrum of gastric juice in clinical screening for gastric cancer

作　　者：孙晓宁[1] 周丽雅[1] 林三仁[1] 赵一鸣[2] 吕旌乔[2] 

机构地区：[1]北京大学第三临床医院消化科,100083 [2]北京大学流行病学研究中心,100083

出　　处：《中华消化杂志》2004年第5期266-269,共4页Chinese Journal of Digestion

摘　　要：目的　验证和评估胃液固有荧光光谱检测在胃癌临床筛查中的实际应用价值。方法　收集 15 0 6例胃内良、恶性疾病患者胃液 ,以缓冲液稀释 6 2 .5倍。应用MpF 4型荧光分光光度计进行稀释胃液固有荧光光谱检测。应用Epi6统计软件将实验数据双录入计算机 ,核查后建立数据库。 结果　以2 85nm为激发光 ,在 30 0～ 80 0nm范围内发光光谱有 2个峰 ,分别位于 32 0～ 4 0 0nm及 5 70～ 6 0 0nm处。特征性改变是胃癌患者的第一个荧光峰值 (P1FI)比胃内良性病变患者增高。应用SPSS10 .0软件进行单因素分析 ,选择胃液固有荧光光谱诊断胃癌的工作特征曲线 (ROC)最佳临界点P1FI≥ 76 .5作为判别指标 ,诊断胃癌敏感度为 83.2 % ,特异度为 80 .7% ,准确度为 82 .0 %。应用CARTV2 .0软件建立诊断胃癌分类树判别模型 ,以P1FI≥ 78.5为判定标准 ,诊断胃癌先验概率敏感度为 93.6 % ,特异度为79 .5 % ,准确度为 80 .7% ;后验概率敏感度为 83.2 % ,特异度为 81.3% ,准确度为 81.4 %。结论　稀释胃液固有荧光光谱在胃癌临床筛查中的敏感度、特异度和准确度均较高 ,是一种可以用于胃癌临床筛查的安全简便。Objective To evaluate autofluorescence spectrum determination of gastric juice in clinical screening for gastric cancer. Methods A total number of 1506 gastric juice specimens were collected from the patients underwent gastroscopy. The specimens were diluted by 62.5 times with buffer solution to achieve pH9, then the fluorescence spectrums were detected using MpF 4 fluorescence spectrophotometer. Experimental data were double input using Epi6 software and a database was established after checking. Results The wavelength of excitation was 285 nm, the bandwidth was 3 nm, and the wavelength of emission ranged from 300 800 nm.Two peaks were found in the autofluorescence spectrum of gastric juice from all patients. The first peak was distinctively higher in gastric cancer than that in benign lesion. Single analysis was carried out with SPSS software, and the best critical point P 1FI≥76.5 on receiver operator characteristic curve(ROC) was selected as diagnostic standard for gastric cancer. The sensitivity, specificity, and accuracy of diluted gastric juice's autofluorescence spectrum for diagnosing gastric cancer were 83.2%, 80.7%, and 82.0%, respectively. Synthetic analysis was carried out with CART software to set up the diagnostic model for gastric malignant diseases by P 1FI≥78.5. The model's sensitivity, specificity, and accuracy for prior probability were 93.6%, 79.5% and 80.7%, respectively; for posterior probability were 83.2%, 81.3%, and 81.4%, respectively. Conclusions Autofluorescence spectrum determination of gastric juice had high sensitivity, specificity and accuracy for clinical screening of gastric cancer, so it might be a safe and simple, economical and effective method for clinical screening of gastric cancer.

关 键 词：胃液固有荧光光谱 胃癌 诊断方法 肿瘤 

分 类 号：R735.2[医药卫生—肿瘤]