Chhajed P N, Shibuya K, Hoshino H, Chiyo M, Yasufuku K, Hiroshima K, Fujisawa T
Dept. of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Eur Respir J. 2005 Jun;25(6):951-5. doi: 10.1183/09031936.05.00012504.
The aim of this study was to compare the diagnostic yield of flexible video bronchoscopy (FVB) and autofluorescence bronchoscopy (i.e. lung imaging fluorescence endoscopy (LIFE)) in 151 patients at a high risk of lung cancer and with moderate dysplasia or worse on sputum cytology mass screening. Findings from FVB and LIFE were classified as either normal, abnormal or suspicious for cancer. Endobronchial biopsies (EBX) were obtained from abnormal or suspicious areas on FVB and/or LIFE, or randomly when FVB and LIFE were normal. Moderate dysplasia and worse were defined as pathologically positive. Overall, 83 out of 343 (24%) EBX were pathologically positive. The sensitivity of FVB was 72% and LIFE 96%. Relative sensitivity of LIFE over FVB was 1.33. Specificities of FVB and LIFE were 53 and 23%, respectively. The numbers of pathologically positive EBX from sites designated normal, abnormal or suspicious were: from FVB, 23 out of 162 (14%), 37 out of 151 (25%) and 23 out of 30 (77%); from LIFE, three out of 69 (4%), 44 out of 212 (21%) and 36 out of 62 (58%). In normal or abnormal areas at FVB, there was a significant increase in the yield of EBX guided by abnormal and suspicious sites noted at LIFE. In conclusion, endobronchial biopsies of suspicious findings from lung imaging fluorescence endoscopy and flexible video bronchoscopy have a good diagnostic yield. Lung imaging fluorescence endoscopy is more useful when flexible video bronchoscopy is either normal or abnormal.
本研究旨在比较151例肺癌高危且痰细胞学大规模筛查显示中度发育异常或更严重病变患者的柔性视频支气管镜检查（FVB）和自体荧光支气管镜检查（即肺部成像荧光内镜检查（LIFE））的诊断率。FVB和LIFE的检查结果分为正常、异常或可疑癌症。从FVB和/或LIFE的异常或可疑区域获取支气管内活检（EBX），或者在FVB和LIFE均正常时随机获取。中度发育异常及更严重病变定义为病理检查阳性。总体而言，343例EBX中有83例（24%）病理检查呈阳性。FVB的敏感性为72%，LIFE为96%。LIFE相对于FVB的相对敏感性为1.33。FVB和LIFE的特异性分别为53%和23%。从指定为正常、异常或可疑部位获取的病理检查阳性EBX数量分别为：FVB检查中，162例中有23例（14%）、151例中有37例（25%）、30例中有23例（77%）；LIFE检查中，69例中有3例（4%）、212例中有44例（21%）、62例中有36例（58%）。在FVB检查显示正常或异常的区域，由LIFE检查发现的异常和可疑部位引导获取的EBX阳性率显著增加。总之，对肺部成像荧光内镜检查和柔性视频支气管镜检查的可疑结果进行支气管内活检具有良好的诊断率。当柔性视频支气管镜检查结果正常或异常时，肺部成像荧光内镜检查更有用。
