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自体荧光腹腔镜检查对腹膜子宫内膜异位症病变的检测

Detection of peritoneal endometriotic lesions by autofluorescence laparoscopy.

作者信息

Buchweitz Olaf, Staebler Annette, Tio Joke, Kiesel Ludwig

机构信息

Department of Obstetrics and Gynaecology, University of Münster, Germany.

出版信息

Am J Obstet Gynecol. 2006 Oct;195(4):949-54. doi: 10.1016/j.ajog.2006.02.044. Epub 2006 May 3.

Abstract

OBJECTIVE

This study was undertaken to evaluate the feasibility of autofluorescence laparoscopy in the diagnosis of endometriotic lesions.

STUDY DESIGN

Prospective analysis of 83 consecutive patients undergoing laparoscopy for suspected endometriosis under white light illumination and autofluorescence diagnosis. The study measured total number of endometriotic lesions diagnosed under white light illumination and with autofluorescence diagnosis.

RESULTS

The biopsy-based sensitivity of white light diagnosis alone and white light illumination and autofluorescence for detecting nonpigmented peritoneal endometriotic lesions was 65% compared with 92% (1.42-fold increase). The corresponding specificity was 68% as opposed to 84%. Occult areas of endometriosis were discovered using autofluorescence diagnosis. Statistical analysis was performed with chi2 test and McNemar test.

CONCLUSION

Combination of white light illumination and autofluorescence is significantly superior to white light illumination alone in detecting nonpigmented endometriotic lesions. Autofluorescence diagnosis of nonpigmented endometriotic lesions may become an alternative to fluorescence diagnosis after application of 5-aminolevulinic acid, especially because of no side effects.

摘要

目的

本研究旨在评估自体荧光腹腔镜检查在诊断子宫内膜异位症病变中的可行性。

研究设计

对83例连续接受腹腔镜检查的患者进行前瞻性分析,这些患者因疑似子宫内膜异位症在白光照明和自体荧光诊断下接受检查。该研究测量了在白光照明和自体荧光诊断下诊断出的子宫内膜异位症病变总数。

结果

仅基于活检的白光诊断以及白光照明和自体荧光检测无色素腹膜子宫内膜异位症病变的敏感性分别为65%和92%(增加了1.42倍)。相应的特异性分别为68%和84%。通过自体荧光诊断发现了子宫内膜异位症的隐匿区域。使用卡方检验和麦克尼马尔检验进行统计分析。

结论

在检测无色素子宫内膜异位症病变方面,白光照明与自体荧光相结合明显优于单纯白光照明。无色素子宫内膜异位症病变的自体荧光诊断可能会成为应用5-氨基酮戊酸后荧光诊断的替代方法,尤其是因为其没有副作用。

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