窄带显像技术在肺部病变诊断中的应用

Application of narrow band imaging video-bronchoscopy in diagnosis of lung diseases

摘要:

目的   评价窄带显像技术（NBI）在肺部病变诊断中的应用价值。方法   应用NBI对122例患者进行支气管镜检查，分析不同病变NBI图像特点，并给出NBI模式下病变图像评分，分别计算肺部良性病变与恶性病变的NBI评分并比较；分析比较普通白光模式下与NBI模式下肺癌诊断的灵敏度、特异度、阴性预测值与阳性预测值。结果   活检组肺部良性病变（NBI评分9～11分）与恶性病变（NBI评分13～14分）的表现有明显差异。普通白光模式下肺癌诊断的灵敏度为84.8%，特异度54.7%，阳性预测值38.6%，阴性预测值91.5%。NBI模式下肺癌诊断的灵敏度为93.5%，特异度92.6%，阳性预测值87.8%，阴性预测值96.2%，两组相比差异均有统计学意义。其中，灵敏度P <0.05，特异度与阳性预测值P <0.001，阴性预测值P <0.05。结论   NBI较传统的白光能更为准确地预测肺部病变的病理类型，发现早期肺癌，具有良好的临床应用价值。

关键词:

窄带显像;肺部病变;肺癌;支气管镜

Abstract:

Objective To evaluate the application value of narrow band imaging video-bronchoscopy in diagnosis of lung diseases. Methods 122 cases of patients suffered lung diseases were checked by narrow band imaging bronchoscopy, whose NBI images were analyzed and scored, then comparison between benign diseases and malignant diseases were made. The specificity, sensitivity, positive and negative predictive values of NBI in revealing lung cancer were compared with white light bronchoscopy. Results In the biopsy group there were significant difference between the benign group (NBI score 9～11) and the malignant group (NBI score 13～14). The specificity ,sensitivity, positive and negative predictive values of NBI in revealing lung cancer were 93.5 %, 92.6 %, 87.8 % and 96.2 %, respectively, while white light bronchoscopy were 84.8 %, 54.7 %, 38.6 % and 91.5 %, respectively, there were significant difference between the two techniques (P < 0.05, P < 0.001, P < 0.001 and P < 0.05, respectively). Conclusion Compared with white light bronchoscopy, narrow band imaging vedio-bronchoscopy had better specificity, sensitivity, positive and negative predictive values in the assessment of lung cancer, and it might play a significant role in the therapeutic decision.

Key words:

narrow band imaging; lung diseases; lung cancer; video-bronchoscopy