Wang Hongling, Liu Shuping, Li Fenggang, Gao Wei, Lv Nan
Department of Clinical Laboratory, Shandong Normal University Hospital Jinan 250014, Shandong Province, China.
Medical Research & Laboratory Diagnostic Center, Affiliated Central Hospital of Shandong First Medical University Jinan 250013, Shandong Province, China.
Am J Transl Res. 2021 Jul 15;13(7):7775-7782. eCollection 2021.
This study set out to enhance the positive detection rate of lung tumors, diagnosis of nodular lesions and improve the accuracy of lung cancer classification by evaluating the clinical value of autofluorescence bronchoscopy (AFB).
Forceps biopsy, brush biopsy, needle aspiration, and washing techniques were performed alone and in combination with AFB among 38 subjects who were analyzed cytologically and histologically.
Our results showed that 33 out of 38 patients were diagnosed with lung cancer, with an overall positive diagnostic rate of 86.8% when the combined methods and AFB was performed; the positive diagnostic rates obtained by forceps, needle aspiration, brush biopsy and washing methods were 68.4%, 84.2%, 55.3% and 36.8%, respectively. Compared to the overall positive rate, the positive diagnostic rates detected by forceps and needle aspiration were not statistically significant (P>0.05). However, the positive rates gained by the brush biopsy and washing method were statistically significant (P<0.01). In addition, we compared the 38 cases evaluated with AFB and 43 cases evaluated with "traditional" white light bronchoscopy (WLB), using the same methods.
AFB and WLB markedly improved the positive diagnosis rate when combined with forceps and needle aspiration. The overall positive diagnostic rate of lung cancer scanned by WLB was increased from 60.5% to 86.8% (P<0.01) by using the combined methods of forceps, brush biopsy, needle aspiration and washing. Moreover, the accuracy of lung cancer classification combined with cytology and cell immunohistochemistry was improved. These results showed that a variety of inspection techniques and diagnostic technologies effectively play a complementary role in the diagnosis and classification of lung cancer.
本研究旨在通过评估自发荧光支气管镜检查（AFB）的临床价值，提高肺肿瘤的阳性检出率、结节性病变的诊断水平，并提高肺癌分类的准确性。
对38名受试者单独或联合AFB进行钳取活检、刷检、针吸及灌洗技术，并进行细胞学和组织学分析。
我们的结果显示，38例患者中有33例被诊断为肺癌，联合方法及AFB检查时总体阳性诊断率为86.8%；钳取、针吸、刷检及灌洗方法的阳性诊断率分别为68.4%、84.2%、55.3%和36.8%。与总体阳性率相比，钳取和针吸的阳性诊断率无统计学意义（P>0.05）。然而，刷检和灌洗方法的阳性率有统计学意义（P<0.01）。此外，我们采用相同方法比较了38例接受AFB评估的病例和43例接受“传统”白光支气管镜检查（WLB）评估的病例。
AFB和WLB与钳取和针吸联合使用时显著提高了阳性诊断率。通过钳取、刷检、针吸及灌洗联合方法，WLB扫描的肺癌总体阳性诊断率从60.5%提高到86.8%（P<0.01）。此外，结合细胞学和细胞免疫组织化学提高了肺癌分类的准确性。这些结果表明，多种检查技术和诊断技术在肺癌的诊断和分类中有效发挥了互补作用。
