Department of Respiratory Diseases, General Hospital of People's Liberation Army, Beijing, China.
Lung Cancer. 2011 Aug;73(2):183-8. doi: 10.1016/j.lungcan.2010.12.002. Epub 2011 Jan 14.
It is known that autofluorescence bronchoscopy (AFB) has limited value in detection of lung cancer and preneoplastic lesions. Though a substantial number of studies have evaluated the diagnostic yield of AFB, the variable estimates limited the ability to accurately assess its test performance and future role in clinical practice. The clinical utility of AFB has never been supported by a meta-analysis due to the inconsistent characteristics in some of studies. A meta-analysis was performed to re-examine the diagnostic efficiency of AFB compared with white light bronchoscopy (WLB).
Search of both MEDLINE and EMBASE database up to June 2009 was conducted and hand search was performed against the extracted reference list for relevancy. Included studies had to have a conclusive histology as diagnostic standard, and provided sufficient data to construct a 2X2 table for assessing the diagnostic yield of AFB for detection of lung cancer and preneoplastic lesions. After examining the source of variation, pooled sensitivity and specificity of AFB were estimated using a bivariate random-effects regressing model and compared with that of WLB.
Of 439 publications, 14 studies, providing 15 sets of data, were suitable for analysis. The pooled sensitivity and specificity of AFB and WLB were 0.90 (95% CI 0.84-0.93) and 0.56 (95% CI 0.45-0.66), 0.66 (95% CI 0.58-0.73) and 0.69 (95% CI 0.57-0.79). The contribution of differences in excitation light source, histological criteria and biopsy strategy was not counted as a covariate.
The result indicated that AFB was superior to conventional WLB in detecting lung cancer and preneoplastic lesions.
众所周知，自发荧光支气管镜（AFB）在肺癌和癌前病变的检测方面的价值有限。尽管大量研究已经评估了 AFB 的诊断效果，但由于一些研究中存在变量估计，这些估计值限制了对其检测性能和未来在临床实践中的作用进行准确评估的能力。由于部分研究的特征不一致，AFB 的临床实用性从未得到过荟萃分析的支持。我们进行了荟萃分析，以重新检查 AFB 与白光支气管镜（WLB）相比的诊断效率。
对截至 2009 年 6 月的 MEDLINE 和 EMBASE 数据库进行了检索，并针对提取的参考文献进行了手工检索以寻找相关性。纳入的研究必须具有明确的组织学作为诊断标准，并提供足够的数据来构建 2X2 表格，以评估 AFB 检测肺癌和癌前病变的诊断效果。在检查了变异源之后，使用双变量随机效应回归模型来估计 AFB 的合并敏感性和特异性，并将其与 WLB 进行比较。
在 439 篇出版物中，有 14 项研究，提供了 15 组数据，适合进行分析。AFB 和 WLB 的合并敏感性和特异性分别为 0.90（95%CI 0.84-0.93）和 0.56（95%CI 0.45-0.66）、0.66（95%CI 0.58-0.73）和 0.69（95%CI 0.57-0.79）。未将激发光源、组织学标准和活检策略的差异差异作为协变量进行计数。
结果表明，AFB 在检测肺癌和癌前病变方面优于传统的 WLB。
