Detection of bronchial squamous dysplasia using high magnification bronchovideoscopy and angiogenesis of multi step carcinogenesis of squamous cell carcinoma

本研究的目的是探讨高倍支气管镜在粘膜荧光异常患者支气管黏膜发育不良的详细检查中的价值。本研究采用高倍率支气管镜（XBF 200HM2）。31例痰细胞学怀疑或阳性为恶性肿瘤的患者被纳入研究。在局部麻醉下，先进行常规白光检查。荧光支气管镜检查也可以使用LIFE肺系统。然后，高倍支气管镜主要在正常和异常荧光部位进行高倍观察，检查支气管黏膜微血管网络。我们将高倍率支气管镜所获得的图像与支气管活检标本的病理诊断进行比较。对于高倍率支气管镜所获得的血管形态，用图像分析仪器计算并比较了血管形态与血管形态的比值。支气管炎22个异常荧光位点中有20个可见规律性肌肉网络。然而，在21个异常荧光位点中的15个观察到血管生长增加的血管网络和不同大小的弯曲血管的复杂网络。支气管炎和发育不良之间存在显著差异（OR-25, 95%CI, 5.5 ~ 113, p<0.0001）。16例荧光正常部位的正常支气管上皮，22例支气管炎和21例不典型增生的荧光异常部位的血管面积比平均值（95%可信区间[CI]）分别为0.054 （95%CI=0.039 ~ 0.07）、0.095 （95%CI=0.072 ~ 0.118）和0.173 （95%CI=0.143 ~ 0.203）。结果显示，三组患者血管面积值均有统计学意义升高（p <0.0001）。我们的研究结果表明，高倍支气管镜在异常荧光部位检测到支气管粘膜血管生长增加和复杂的弯曲血管网络，可以区分支气管炎和非典型增生

The purpose of this study was to investigate the value of high-magnification bronchovideoscopy in detailed examination of dysplasia in the bronchial mucosa of patients exhibiting abnormal mucosal fluorescence. A high-magnification bronchovideoscope (XBF 200HM2) was used in this study. A total of 31 patients with sputum cytology suspicious or positive for malignancy were entered into the study. Conventional white-light examination was first performed on patients under local anesthesia. Fluorescence bronchoscopic examination was also caned out using a LIFE lung-system. Then, high-magnification observation was performed by high-magnification bronchovideoscopy primarily at sites of normal and abnormal fluorescence to examine the microvascular network in the bronchial mucosa. Images obtained by high-magnification bronchovideoscopy were compared with pathological diagnoses from bronchial biopsy specimens. For the vascular patterns obtained by high-magnification bronchovideoscopy, vascular ar … More ea ratios were calculated using an image-analyzing apparatus and compared. Mascular networks with regular patterns were observed in 20 of 22 abnormal fluorescence sites with bronchitis. However, vascular networks with increased vessel growth and complex networks of tortuous vessels of various sizes were observed in 15 of 21 abnormal fluorescence sites with dysplasia. There was a significant difference between bronchitis and dysplasia (OR-25, 95%CI, 5.5 to 113, p<0.0001). Vascular area ratios with the means (95% confidence interval [CI])from the 16 normal bronchial epithelium at sites of normal fluorescence, 22 bronchitis and 21 dysplasia at sites of abnormal fluorescence, were 0.054 (95%CI=0.039 to 0.07), 0.095 (95%CI=0.072 to 0.118), and 0.173 (95%CI=0.143 to 0.203), respectively. The results indicated a statistically significant increase in vascular area values in the three group (p <0.0001). Our results showed that areas of increased vessel growth and complex networks of tortuous vessels in the bronchial mucosa detected by high magnification bronchovideoscope at sites of abnormal fluorescence may allow for discrimination between bronchitis and dysplasia Less