激光诱发自体荧光光谱区分肺癌组织和正常肺组织的研究

摘要

To obtain the criterion of Laser-induced Autofluorescence (LIF) spectroscopy in the differentiation of normal lung tissue and lung cancer and study the feasibility of LIF spectroscopy in the diagnosis of lung cancer, the LIF spectra of normal lung and lung cancer in 42 surgical specimens have been measured with a detecting system which consists of an YAG laser(wavelength 355nm) and an optical multichannel analyzer(OMA). Spectroscopic differences between normal lung and cancerous tissues have been found which could be used as a criterion to distinguish from them . The pathological examinations were done to compare with the criterion. The results showed:① The location of the principal spectral peaks of the normal lung tissue (470.8±6.3)nm and lung cancer (463.7±4.8)nm are different(P<0.01), there is a red shift in the peak emission wavelength in normal lung tissue; and the fluorescence intensity of the lung cancer is higher than that of the normal lung tissue. ② In the normal lung tissue spectrum, there are two subsidiary maxima located clearly at 560 and 600nm and the cancer tissue spectrum shows an almost structureless and smoother profile with no subsidiary maxima. The mean fluorescence intensity ratio values at 560nm and 600nm were 0.842±0.158 for normal lung tissue and 1.269±0.147 for lung cancer(P<0.01). ③ The criterion for detection of lung cancer: the peak emission wavelength is shorter than 466.5nm; the fluorescence intensity ratio of I580nm/I600nmis larger or equal to 1.073. Compared with the pathological findings, the criterion can differentiate lung cancer from normal lung tissues with the sensitivity, specificity, positive predictive value and negative predictive value of 93.2%, 88.1%, 89.6% and 98.3% respectively.%为确立激光诱发自体荧光（LIAF）光谱，区分肺癌组织和正常肺组织的判断依据，探讨应用激光诱发荧光（LIF）光谱方法诊断肺癌的可行性。收集肺癌手术标本42例，使用三倍频YAG激光（波长355nm）和多光道分析仪(OMA)测定肺癌标本的LIF光谱，根据正常肺组织和肺癌组织的LIAF光谱特征，寻找能够区分两者的光谱差异，得出判断依据，并与病理结果比较。结果显示：①正常肺组织主峰（470.8±6.3）nm 较肺癌（463.7±4.8） nm向长波侧偏移（P<0.01），肺癌组织的荧光强度大于正常肺组织；②正常肺组织在580nm与600nm的荧光强度比为0.842±0.158，肺癌为1.269±0.147（P<0.01）；③肺癌阳性判断标准域值：主峰波长λ<466.5nm；荧光强度比值为I580nm/I600nm≥1.073；与病理结果比较，符合荧光强度比值判断依据的判断敏感性为93.2%，特异性为88.1 %，阳性预测值为89.6%，阴性预测值为98.3%。