摘要
目的 探讨利用激光诱发荧光 (LIF)光谱对肺癌进行临床诊断的可行性。 方法 使用 35 5nm的Nd :YAG激发光和荧光探测系统 ,将特制光导纤维通过纤维支气管镜的活检通道送入患者支气管 ,对 2 1例患者的正常支气管壁及可疑部位进行LIF光谱测定 ,随后在各检测点咬取组织行病理检查。 结果 2 1例患者共测定 74条曲线 ,经病理证实 ,肺癌 32条 ,正常支气管组织 42条。正常支气管组织主峰 (46 2 4± 7 5 )nm、肺癌主峰 (46 0 5± 7 0 )nm ,两者差异无显著性意义 (P >0 0 5 ) ;正常支气管组织的荧光强度为 (8435 2± 5 0 42 8) ,明显大于肺癌组织 (336 0 2± 196 0 9)差异有显著性意义(P <0 0 1) ;正常支气管组织在 5 80～ 6 0 0nm波段表现为一小坪 (I580nm/I60 0nm=1 0 6 4± 0 133) ,而肺癌平滑下降 (I580nm/I60 0nm=1 32 9± 0 0 85 ) ,差异有显著性意义 (P <0 0 1)。以I580nm/I60 0nm比值为判断值 (S≥ 1 2 2 1为肺癌 ,S <1 2 2 1为正常支气管组织 )诊断肺癌的敏感性、特异性、阳性预测值、阴性预测值及总符合率分别为 87 5 %、80 9%、77 8%、89 5 %和 83 8%。 结论 用LIF光谱对肺癌进行临床诊断是可行的。
Objective To explore the clinic a l feasibility of laser induced fluorescence (LIF)spectroscopy in the diagnosi s of lung cancer. Methods The LIF spectra of t he normal bronchus and doubtful sites of lung cancer in 21 patients with lung ca ncer were measured with a detecting system consisting of an YAG laser(wave lengt h 355 nm) and an optical multichannel analyzer(OMA). A specially made optical fi bre was placed in the patient′s bronchus under a bronchoscope. The detected sit es were biopsied. Results Seventy four spe ctrum curves were detected lung cancer (32 patients) and normal bronchus confirm ed by pathologically (42). The location of the principal spectral peaks of the n ormal bronchial tissue (462.4±7 5)nm and lung cancer(460 5±7 0)nm, showed no significant difference ( P >0 05). The fluorescence intensity o f the normal bronchial tissue(84?352±50?428) was much higher than that of lung cancer (33?602±19?609)( P <0 001). The shape of spectrum betwee n the normal bronchial tissue and lung cancer was different at the right site of the peak. A flat spectrum was observed in the normal bronchial tissue at the wa ve length of 580 nm to 600 nm (I 580nm /I 600nm =1 064±0 133), while the cancer ti ssue spectrum showed a smooth descending profile (I 580nm /I 600nm =1 3 29±0 085). When the fluorescence intensity ratio of I 580nm /I 600nm larger or equal to 1 221 was used, the sensitivity, specificity, positive predi ctive value, negative predictive value and the overall accuracy of LIF spectrosc opy for detection of lung cancer were 87 5%, 80 9%, 77 8%, 89 5% and 83 8%, respectively. Conclusion LIF spectroscopy in the clinical diagnosis of lung cancer is feasible.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2001年第5期364-367,共4页
Chinese Journal of Surgery
关键词
荧光光谱法
激光
肺肿瘤
计算机辅助诊断
内窥镜
LIF
Spectrometry,fluorescence
Lasers
Lung neoplasms
Diagnosis, computer assisted
Endoscopy
