窄波成像技术在肺癌诊断中的应用初探

Narrow band imaging (NBI) bronchoscopy for the diagnosis of endobronchial lung cancer

摘要:

目的 探讨窄波成像技术（NBI）对中央型支气管肺癌的诊断价值。方法 2012年8月-2013年8月，对44例普通白光支气管镜下支气管腔内病变进行NBI检查，根据是否有典型的肿瘤血管（点状、扭曲或突然终止的黏膜下血管），判断NBI为阳性或阴性，并用活检钳进行钳夹活检，病理学诊断由该院病理科进行。结果 44例患者均获得明确病理学诊断结果。33例NBI下肿瘤血管阳性病变中，诊断肺癌29例，良性病变4例；11例NBI肿瘤血管阴性病变中良性病变9例、肺癌2例。NBI诊断支气管腔内肺癌的敏感性为93.5%，特异性为69.2%，阳性预测值87.9%，阴性预测值81.8%，诊断准确率达到86.4%。NBI检查无明显副作用及并发症。结论 NBI技术提高了支气管腔内肺癌的诊断准确性，在肺癌的诊断中具有很高的应用价值。

Abstract:

【Objective】 To evaluate the accuracy of narrow band imaging videobronchoscopy (NBI) in the diagnosis of endobronchial lung cancer. 【Methods】 From Aug. 2012 to Aug. 2013, 44 patients with endobronchial lesions identified by white light bronchoscope were examined by NBI. Existence of pathological patterns of submucosal vessels (dotted, tortuous and abrupt-ending blood vessels) was regarded as NBI-positive, otherwise NBI-negative. All the patients were biopsied with forceps under the guidance of NBI. The pathological diagnosis was conducted by the pathologists in the same hospital. 【Results】 Of the 44 patients, 33 patients were positive and 11 were negative for cancerous vessel patterns under NBI. Pathologically, 29 patients were diagnosed as lung cancer in 33 NBI-positive patients, and 2 patients were diagnosed as lung cancer in 11 NBI-negative patients. The diagnostic sensitivity and specificity of NBI for endobronchial cancer was 93.5% and 69.2% respectively, the positive and negative predictive value of NBI for endobronchial cancer was 87.9% and 81.8% respectively, and the overall diagnostic accuracy of NBI for endobronchial cancer was 86.4%. No major complications were observed during the examination. 【Conclusion】 Our results showed that NBI is a safe technique that can be daily used for accurately and effectively detection of endobronchial cancer.