Escarguel B, D'Amore D, Chapel F, Bec J, Audigier-Valette C, Lahlah H, Milhe F, Marqueste L
Service de Pneumologie, Centre Hospitalier Intercommunal Toulon-La-Seyne, Hôpital Font-Pré, BP 1412, 83056, Toulon Cedex, France.
Rev Pneumol Clin. 2009 Oct;65(5):287-91. doi: 10.1016/j.pneumo.2009.04.005. Epub 2009 Sep 30.
Less than 15% of all patients survive five years after a diagnosis of lung cancer. This poor prognosis is attributed to a lack of early detection. Among the methods of early diagnosis of bronchial cancer, autofluorescence bronchoscopy allows for the early identification of preinvasive bronchial lesions. The goal of this prospective study is to evaluate the contribution of the autofluorescence bronchoscopy, on a hospital site, over a period of one year.
All patients with an indication of autofluorescence bronchoscopy were included in the study. The following parameters were collected: age, sex, smoking status, FEV1, FVC, biopsy sites, histology, duration of examination.
Two hundred and seventy-four patients were included. The average age was 63.8 years (+/-12), the smoking status was 35 packs/year (+/-19). A fluorescence abnormality was detected in 131 patients and 165 sites were biopsied. An histological abnormality was found in 76% of the samples, with 34 hyperplasia (28%), 56 squamous metaplasia (46%), three mild dysplasia (3%), two moderate dysplasia (2%), one severe dysplasia (1%), two carcinomas in situ (2%) and 21 invasive carcinomas (18%).
Autofluorescence bronchoscopy is an effective examination for the detection of the preinvasive neoplasic lesions and may be proposed when lung cancer is suspected.
在所有肺癌确诊患者中,不到15%的患者能存活五年。这种不良预后归因于缺乏早期检测。在支气管癌的早期诊断方法中,自体荧光支气管镜检查可实现对侵袭前支气管病变的早期识别。本前瞻性研究的目的是评估医院环境下自体荧光支气管镜检查在一年期间的作用。
所有有自体荧光支气管镜检查指征的患者均纳入本研究。收集了以下参数:年龄、性别、吸烟状况、第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、活检部位、组织学、检查持续时间。
共纳入274例患者。平均年龄为63.8岁(±12),吸烟状况为每年35包(±19)。在131例患者中检测到荧光异常,对165个部位进行了活检。在76%的样本中发现组织学异常,其中34例为增生(28%),56例为鳞状化生(46%),3例为轻度发育异常(3%),2例为中度发育异常(2%),1例为重度发育异常(1%),2例为原位癌(2%),21例为浸润性癌(18%)。
自体荧光支气管镜检查是检测侵袭前肿瘤性病变的有效检查方法,当怀疑肺癌时可采用。