摘要
目的比较自发荧光实时成像技术（AFI）与普通光支气管镜（WLB）诊断肺癌及癌前病变的灵敏度及特异度，并探讨在临床支气管镜检查中常规应用AFI技术的可行性。方法在MEDLINE和EMBASE上检索近10年的相关文献，再手工检索纳入文献。由2位研究人员独立筛选文献，评估其质量并提取数据。用ReviewManager5．0N算AFI与WLB在诊断肺癌及癌前病变方面总的灵敏度、特异度、相对危险度（RR）。结果检索得到2339篇文献，最终7项研究可用于汇总数据分析。AFI组512例病理阳性，其中464例镜下阳性；WLB组517例病理阳性，其中371例镜下阳性。AFI、WLB的汇总灵敏度分别为90．6％（464／512）、71．8％（371／517），P=0．0004，RR=1．28，95％可信区间（95％CI）为1．11～1．46。即AFI在诊断肺癌及癌前病变方面灵敏度较WLB高。AFI组725例病理阴性，其中567例镜下阴性；WLB组720例病理阴性，其中590例镜下阴性。AFI、WLB的汇总特异度分别为78．2％（567／725）、81．9％（590／720），P=0．53，RR=0．93，95％CI为0．74～1．17。即AFI在诊断肺癌及癌前病变方面特异度不比WLB低。结论AFI在诊断肺癌及癌前病变方面灵敏度较WLB高，而且其特异度并不比WLB低。加之其切换自由，使用方便，安全可靠，可常规用于临床支气管镜检查。
Objective To compare the sensitivity/specificity of autofluorescence imaging bronchoscopy （AFI） with that of white light bronchoscopy （WLB） in the diagnosis of lung cancer and precancerous lesion. Methods The literatures were searched within recent ten years in MEDLINE and EMBASE databases and then searched in the reference lists of relevant literatures for further data. Two reviewers independently assessed the quality of these trials and extracted data. The sensitivity, specificity and relative risk for sensitivity and specificity of AFI versus WLB to detect lung cancer and precancerous lesions were pooled by Review Manager 5.0 software package. Results Of 2 339 publications, seven studies were ultimately suitable for analyzing. In AFI group, there were a total of 512 pathologic positive biopsy sites, and AFI could detect 464 sites from them. In WLB group, there were a total of 517 pathologic positive biopsy sites, and WLB could detect 371 sites from them. The pooled sensitivity of AFI and WLB for detecting lung cancer and precancerous lesions was 90.6% （464/512） and 71.8% （371/ 517）, respectively （ P = 0. 000 4）. The pooled relative sensitivity （compared with WLB） of AFI was 1.28 （95%： （CI ：1.11-1.46）. That meant AFI had higher sensitivity for detecting lung cancer and precancerous lesion. In AFI group, there were a total of 725 pathologic negative biopsy sites, and AFI could detect 567 sites from them. In WLB group, there were a total of 720 pathologic negative biopsy sites, and WLB could detect 590 sites from them. The pooled specificity of AFI and WLB to diagnose lung cancer and precancerous lesions was 78.2% （567/725） and 81.9% （590/720）, respectively （ P = 0.53）. The pooled relative specificity （compared with WLB） of AFI was 0.93 （95% CI ：0.74-1.17）. which meant specificity of AFI was not lower than that of WLB. Conclusions AFI has higher sensitivity in detecting lung cancer and precancerous lesion, and its specificity is not lower than WLB. Besides,
出处
《国际呼吸杂志》
2013年第2期88-93,共6页
International Journal of Respiration
基金
国家自然科学基金资助项目（81270144、30800507、81l70071）
关键词
自发荧光实时成像技术
自发荧光支气管镜
普通光支气管镜
肺癌
癌前病变
Autofluorescence imaging bronchoscopy
Autofluorescence bronchoscopy
White light bronehoscopy
Lung cancer
Precancerous lesion
