The clinical value of autofluorescence bronchoscopy for the diagnosis of lung cancer
The clinical value of autofluorescence bronchoscopy for the diagnosis of lung cancer
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DOI：
10.1183/09031936.06.00131405
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发表时间：
2006-11-01
影响因子：
24.3
通讯作者：
Lam, W. K.
中科院分区：
文献类型：
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作者：
Lam, B.;Wong, M. P.;Lam, W. K.
本研究的目的是评估自发荧光支气管镜检查（AFB）在肺癌常规检查中的作用。招募了连续的痰或支气管吸出物中存在非典型或可疑细胞、胸部X线检查无局部异常和非诊断性的患者。白光支气管镜（WLB）结果。WLB和AFB在同一阶段中顺序进行。所有通过WLB、AFB或两者检测到的异常区域均被取样，并将活检标本送去进行组织学检查。17例未检出支气管内病变。在45例支气管内病变患者中，37例病变的组织病理学分级为轻度异型增生或更低;在8例病变的组织学分级为中度异型增生或更差的患者中，发现5例肺癌，2例浸润性肺癌和3例上皮内肿瘤（重度异型增生）。病变显示中度异型增生或更严重的可疑细胞比那些非典型细胞痰检查的患者更常见。AFB在检测这些病变方面比WLB更敏感（91%比58%），但特异性较低（26%比50%）。
The aim of this study was to evaluate the role of autofluorescence bronchoscopy (AFB) in the routine work-up of lung cancer.Consecutive patients with atypical or suspicious cells in sputum or bronchial aspirate, no localising abnormality on chest radiography and nondiagnostic white-light bronchoscopic (WLB) results were recruited. WLB and AFB were performed sequentially during the same session. All abnormal areas detected by WLB, AFB or both were sampled and the biopsy specimens sent for histological examination.Sixty-two patients were recruited within the 32-month study period. Seventeen had no endobronchial lesion detected. Among the 45 patients with endobronchial lesions, 37 had lesions with a histopathological grade of mild dysplasia or less; of the eight patients who had a lesion with a histological grade of moderate dysplasia or worse, five were found to have lung cancer, two invasive lung cancer and three an intra-epithelial neoplasm (severe dysplasia). Lesions showing moderate dysplasia or worse were more commonly found in patients with suspicious cells than in those with atypical cells on sputum examination. AFB was more sensitive than WLB (91 versus 58%) at detecting these lesions, but less specific (26 versus 50%).A combination of white-light and autofluorescence bronchoscopy can increase the diagnostic yield of this invasive procedure in patients exhibiting abnormal sputum cytology.