大肠癌体内激光诱发荧光光谱分析解读.docxVIP

大肠癌体内激光诱发荧光光谱分析 【摘要】　目的　研究体内大肠癌、腺瘤性息肉、慢性炎症与正常组织的 激光诱发荧光(LIF)光谱，重点探讨癌前病变的特征性光谱规律。方法　将与氮 分子激光器（激发波长?337?nm）耦合的光纤经纤维结肠镜活检孔插入，激光由 光纤导入，分别检测?83?例患者体内病变组织（包括大肠癌?39?例，腺瘤性息肉 33?例，慢性炎症?23?例）与正常组织的?LIF?光谱，所得光谱由同根光纤导出， 由?OMA?Ⅲ进行记录、分析处理。结果　癌与正常组织的光谱强度及形态存在差 异：①正常组织的光谱强度明显高于癌组织。②癌组织的主峰波长较正常组织 向红光侧移动。③癌组织的次峰下降较正常组织缓慢。根据以上特点，选择主 峰强度（x1）、Ⅰ?400?nm/Ⅰ?530?nm（x2）和集成荧光强度（350?nm～600 nm）（x3）等?3?个参数求得判别方程，诊断大肠癌的敏感性和特异性分别为 83.3%和?94.4%，伴有中-重度不典型增生腺瘤性息肉?87.1%判别为异常。结论　 LIF?光谱可以在体内将大肠癌组织与正常组织区别开来，尤其是对不典型增生 的鉴别能力较强，提示?LIF?对于大肠癌的早期诊断有非常重要的意义。 　　【主题词】　结直肠肿瘤/诊断；　激光诱发荧光；　光谱分析 Laser-induced?fluorescence?(LIF)?spectrum?of?colorectal cancer?in?vivo LI?Jing,?LI?Shirong,?GAO?Ge,?et?al. （The?Air?Force?General?Hospital,?Beijing?100036,?China） 　　【Abstract】　Objective　To?study?the?LIF?spectrum?of?colorectal cancer,?adenomas,?chronic?colitis?and?normal?colon?tissue?in?vivo, with?special?emphasis?on?precancerous?lesions.Methods　A?nitrogen laser?(wave-length?337?nm)?beam?was?introduced?through?endoscopic colonoscope?and?the?fluorescence?emission?was?recorded.?An?optical multichannel?analyzer?(OMA?Ⅲ)?was?used?to?analyze?the?fluorescence emission?spectrum.?A?total?of?83?patients?was?exanmined.Results　The emission?spectrum?of?LIF?recorded?on?colorectal?cancer?and?normal tissue?showed?significant?differences?in?intensity?and?shape.?(1)?The normal?tissue?had?higher?intensity?than?that?of?cancer?tissue.?(2) The?main?peak?wavelength?of?cancer?moved?to?the?red.?(3)?The?minor peak?of?the?cancer?tissue?fell?more?slowly?than?that?of?the?normal tissue.?Intensity?of?the?main?peak?(x1),?intensity?ratio?of?400?to 530?nm?(x2)?and?the?integrated?LIF?intensity?(350～600?nm)?(x3)?were used?as?parameters?to?obtain?an?equation.?The?sensitivity?and specificity?of?LIF?for?diagnosis?of?colorectal?cancer?was?83.3%?and 94.4%,?respectively.?In?87.1%?of?moderate?and?severe?dysplastic adenomatous?polyps,?the?fluorescence?spectrum?was?abnormal.Conclusion　 In?vivo,?the?LIF?spectrum?can?be?used?to?distinguish?colorectal cancer?from?normal?col