稀释胃液固有荧光光谱对胃癌诊断价值的研究详解.ppt

稀释胃液固有荧光光谱对胃癌诊断价值的研究 研究背景 胃癌是人类最常见的恶性肿瘤之一。目前尚未找到一种高灵敏度、高特异度的实验室检查方法用于胃癌的筛查及诊断。已有研究表明, 胃液固有荧光光谱检测对胃癌的诊断有一定意义, 但敏感度和特异度有待提高。 研究目的 评价胃液固有荧光光谱检测对胃癌诊断的价值, 并初步探讨了胃液浓度对荧光光谱的影响。 研究方法 胃液稀释后 ,应用 RF 5000 型荧光分光光度计 ,以 288nm为激发光 ,测定 300～ 800nm发射光范围内的荧光光谱。 研究结果 共测定了 251例各种胃内良、恶性病变患者 (其中进展期胃癌 39例 ,重度异型增生 1例)的稀释胃液固有荧光光谱 ,发现原有胃液固有荧光光谱有 3个峰 ,稀释后胃液固有荧光光谱的峰位和峰数不变 ,仅相对荧光强度指数 (F1)改变。 研究结果 胃癌患者稀释胃液 (体积比 1∶2 0 )固有荧光光谱的峰位和峰数与胃内良性病变患者基本相同 ,仅第 1峰 (位于 320 ～ 360nm处 )的相对荧光强度指数 (P1FI)增大。 研究结果 用CART V2 .0软件进行分析 ： 如以P1FI 38.995为胃癌诊断标准 ,用于诊断胃癌的先验概率的敏感度为 85 .0 % ,特异度为 91.9% ;后验概率的敏感度为 82 .5 % ,特异度为 91.9%。 如以P1FI 24.34作为胃癌阳性判定标准 ,则诊断胃癌的敏感度为 95 .0 % ,特异度为 75 .8%。 胃癌判别分类树 结论 稀释后的胃液固有荧光光谱可能成为有效的胃癌临床诊断及筛查手段。 A novel approach for the detection of early gastric cancer: fluorescence spectroscopy of gastric juice OBJECTIVE This study aimed to investigate the efficacy of fluorescence spectroscopy of gastric juice for early gastric cancer (EGC) screening. METHODS Gastric juice was collected from 101 participants who underwent endoscopy in the Outpatient Endoscopy Center of?Peking?UniversityThird?Hospital. The participants were divided into three groups: the normal mucosa or chronic non-atrophic gastritis (NM-CNAG) group (n?=?35), advanced gastric cancer (AGC) group (n?=?33) and EGC group (n?=?33). METHODS Fluorescence spectroscopic analysis was performed in all the gastric juice samples and the maximum fluorescence intensity of the first peak (P1FI) was measured. RESULTS The mean fluorescence intensity of P1FI of gastric juice in AGC (92.1?±?10.7) and EGC (90.8?±?12.0) groups was significantly higher than that in the NM-CNAG group (55.7?±?7.5) (AGC?vs?NM-CNAG, P?=?0.006 and EGC?vs?NM-CNAG, P?=?0.015, respectively). RESULTS The areas under the receiver operating characteristic curves for the detection of AGC and EGC were 0.681 (95% confidence interval [CI] 0.553-0.810, P?=?0.010) and 0.655 (95% CI 0.522-0.787, P?=?0.028). RESULTS With the P1FI of ≥47.7, the sensitivity, specificity and accuracy for detecting E