摘要
目的：评价内镜下激光诱发自体荧光光谱诊断胃癌的临床应用价值。方法：采用氦镉（Ｈｅ－Ｃｄ）激光系统（激发波长４４２ｎｍ）对３８例经病理活检证实的胃癌和慢性胃炎患者进行自体荧光光谱检测，并作自身对照研究。结果：在内镜下以氦镉激光诱发的胃癌自体荧光光谱含主峰（５１０ｎｍ附近）和３个次峰（５９０ ｎｍ、６７０ ｎｍ和７１０ ｎｍ附近），光谱强度和形态与正常组织有显著差异。以荧光强度（ＦＩ）６６２～６７７ ｎｍ和ＦＩ ７０１～７１６。的积分及ＦＩ ５１０ ｎｍ／ＦＩ ７１０ｎｍ的比值３个参数作判别分析，自体荧光光谱诊断胃癌的敏感性、特异性及阳性和阴性预测值分别为８２．９％、９１．５％和8７．９％、８７．８％，其诊断准确率为８７．８％。结论：内镜下对胃癌的自体荧光检测具有实时发现病灶、帮助引导活检的重要作用，有望成为早期胃肠道癌肿诊断的有效辅助工具。
Background/Aims: To evaluate the clinical application of laser-induced fluorescence(LIF) spec- tra in diagnosing gastric cancer by gastroscopy. Methods: Helium-Cadmium laser system(excitation wavelength 442 nm) was used to detect the autofluorescence in gastric cancer, chronic gastritis and corresponding normal tissues in 38 patients identified by endoscopy and biopsy. Results: LIF spectra of gastric cancer excited by Helium-Cadmium laser have one major peak(near 510 nm) and three minor peaks(near 590 nm, 670 nm, 710 nm). The intensity and the shape of LIF spectra between gastric cancer and normal tissue were different significantly. Using the integral fluorescence intensity(Fl) at 662～ 677 nm and 701～716 nm, and the ratio FI 510 nm/FI 710 nm as the diagnostic parameters, it was possi- ble to diagnose gastric cancer with 82.9% sensitivity, 91.50/o specificity, 87.9% positive predictive value and 87.8% negative predictive value. The diagnostic accuracy was 87.8%. Conclusions: The diagnosis of gastric cancer by autofluorescence spectroscopy has the advantages of real-time detection of the gastric cancerous lesion and it serves as a guide to take biopsy specimens. Hopefully it potentially be- come a useful tool in the diagnosis of early gastric cancer.
出处
《胃肠病学》
2002年第1期21-23,41,共4页
Chinese Journal of Gastroenterology
