Li Yun, Li Xiao, Sui Xi-Zhao, Bu Liang, Zhou Zu-Li, Yang Fan, Liu Yan-Guo, Zhao Hui, Li Jian-Feng, Liu Jun, Jiang Guan-Chao, Wang Jun
Department of Thoracic Surgery, People's Hospital, Peking University, Beijing 100044, P. R. China.
Chin J Cancer. 2010 Dec;29(12):1018-22. doi: 10.5732/cjc.010.10298.
The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitively, but it has seldom performed in China. To assess the clinical value of the AFB in airway examination, we compared the sensitivity and specificity of the AFB and WLB in detecting cancer of the airway mucosa.
Between September 2009 and May 2010, bronchoscope examinations using both the AFB and WLB were performed on 136 patients, 95 men and 41 women with a median age of 61.5 years (ranged from 25 to 84 years). There were 46 lesions located in the central airway, 84 in the peripheral lung parenchyma, and 6 in the mediastinal region. All patients received local and general anesthesia and were subsequently examined with the WLB and AFB in tandem. All procedures were completed safely. Abnormal visual findings were recorded, and biopsies of the affected regions were collected for pathologic examination.
Of 241 regions sampled for biopsy, 76 sites contained malignant lesions, whereas 165 sites contained benign lesions. The AFB detected 72 of the 76 malignant lesions, but the WLB detected only 50. The sensitivities of the AFB and WLB were 94.7% and 65.8%, respectively, and the specificities were 57.0% and 83.6%, respectively. The negative predictive values of the AFB and WLB were 95.9% and 84.1%, respectively.
The AFB is more sensitive than the WLB in detecting cancerous lesions in the mucosa, and is an effective airway examination.
白光支气管镜检查（WLB）在气道检查中的敏感性和准确性较低。自体荧光支气管镜（AFB）能够更敏感地检测支气管黏膜早期病变，但在中国应用较少。为评估AFB在气道检查中的临床价值，我们比较了AFB和WLB检测气道黏膜癌的敏感性和特异性。
2009年9月至2010年5月，对136例患者进行了AFB和WLB检查，其中男性95例，女性41例，中位年龄61.5岁（25至84岁）。中央气道病变46处，外周肺实质病变84处，纵隔病变6处。所有患者均接受局部和全身麻醉，随后依次进行WLB和AFB检查。所有操作均安全完成。记录异常视觉发现，并采集病变部位活检组织进行病理检查。
在241个活检采样区域中，76个部位为恶性病变，165个部位为良性病变。AFB检测出76个恶性病变中的72个，而WLB仅检测出50个。AFB和WLB的敏感性分别为94.7%和65.8%，特异性分别为57.0%和83.6%。AFB和WLB的阴性预测值分别为95.9%和84.1%。
AFB在检测黏膜癌性病变方面比WLB更敏感，是一种有效的气道检查方法。
