1 Department of Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
2 Department of Electronic Engineering, Shanghai Jiao Tong University, Shanghai, China.
Technol Cancer Res Treat. 2017 Aug;16(4):482-487. doi: 10.1177/1533034616656466. Epub 2016 Jul 19.
Autofluorescence bronchoscopy shows good sensitivity and poor specificity in detecting dysplasia and cancer of the bronchus. Through quantitative analysis on the target area of autofluorescence bronchoscopy image, determine the optimal identification index and reference value for identifying different types of diseases and explore the value of autofluorescence bronchoscopy in diagnosis of lung cancer. Patients with 1 or more preinvasive bronchial lesions were enrolled and followed up by white-light bronchoscope and autofluorescence bronchoscopy. Color space quantitative image analysis was conducted on the lesion shown in the autofluorescence image using MATLAB image measurement software. A retrospective analysis was conducted on 218 cases with 1208 biopsies. One hundred seventy-three cases were diagnosed as positive, which included 151 true-positive cases and 22 false-positive cases. White-light bronchoscope associated with autofluorescence bronchoscopy was able to differentiate between benign and malignant lesion with a high sensitivity, specificity, positive predictive value, and negative predictive value (92.1%, 59.3%, 87.3%, and 71.1%, respectively). Taking 1.485 as the cutoff value of receiver operating characteristic of red-to-green value to differentiate benign and malignant diseases, the diagnostic sensitivity reached 82.3% and the specificity reached 80.5%. U values could differentiate invasive carcinoma and other groups well. Quantitative image analysis method of autofluorescence bronchoscopy provided effective scientific basis for the diagnosis of lung cancer and precancerous lesions.
自发荧光支气管镜检查在检测支气管异型增生和癌变方面具有较好的敏感性和较差的特异性。通过对自发荧光支气管镜图像的目标区域进行定量分析,确定识别不同类型疾病的最佳鉴别指标和参考值,探讨自发荧光支气管镜在肺癌诊断中的价值。纳入 1 个或 1 个以上的支气管病变,采用白光支气管镜和自发荧光支气管镜对病变进行随访。使用 MATLAB 图像测量软件对自发荧光图像中显示的病变进行颜色空间定量图像分析。对 218 例共 1208 个活检标本进行回顾性分析。173 例诊断为阳性,包括 151 例真阳性和 22 例假阳性。白光支气管镜联合自发荧光支气管镜能够很好地区分良性和恶性病变,具有较高的敏感性、特异性、阳性预测值和阴性预测值(分别为 92.1%、59.3%、87.3%和 71.1%)。以红/绿比值的受试者工作特征曲线的 1.485 作为鉴别良恶性疾病的截断值,诊断的敏感性为 82.3%,特异性为 80.5%。U 值能够很好地区分浸润性癌和其他组。自发荧光支气管镜的定量图像分析方法为肺癌及癌前病变的诊断提供了有效的科学依据。