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目的 内镜下激光诱发荧光活检引导技术已日趋成熟 ,但仪器的昂贵限制了这种技术的开发与使用。本研究拟采用光 电信号转换系统代替弱光检测仪 (OMA) ,进行临床验证。方法 根据4 2例已知胃肠道癌组织的荧光谱特征 ,建立两个荧光判别公式。依据公式要求 ,研制新的荧光活检引导仪。以该仪器和OMA仪同步检测 15例体外胃肠道癌和 4 0例内镜下疑为癌的病例 ,并计算其判断敏感性和特异性。结果 1.根据已知病例 ,建立了癌判别公式 :①组织荧光总能量 =35 9～ 6 5 9nm的荧光积分 ;②组织荧光能量积分比 =W3 95～ 460nm/W460～ 659nm。以公式②判别 15例体外胃肠道癌的敏感性为93.3% ,特异性 10 0 .0 %。以公式②判别内镜下胃肠道癌的敏感性为 90 .0 % ,特异性为 92 .5 %。结论 该仪器可协助内镜医师实时、无创地判断镜下病变性质。新的荧光活检引导仪在判别胃肠道良、恶性病变的效能上与国际上广泛应用的OMA相等 ,仪器的成本仅相当于购入OMA检测设备的十分之一
Objective Endoscopic laser-induced fluorescence biopsy guidance technology has matured, but the expensive instruments to limit the development and use of this technology. This study intends to use optical signal conversion system instead of weak light detector (OMA) for clinical validation. Methods Based on the fluorescence characteristics of 42 cases of known gastrointestinal cancer tissues, two fluorescence discriminant formulas were established. According to the formula requirements, the development of new fluorescent biopsy guide instrument. The instrument and the OMA instrument simultaneously detected 15 cases of gastrointestinal cancer in vitro and 40 cases of suspected cases of endoscopic cancer, and calculate the sensitivity and specificity of its judgment. According to the known cases, a discriminant formula of cancer was established: (1) fluorescence integral of the total fluorescence of the tissue = 35 9 ~ 659 nm; (2) integral energy of the fluorescence of the tissue = W3 95-460 nm / W 460-665 nm. To formula ② discriminant in 15 cases of gastrointestinal cancer sensitivity was 93.3%, specificity 100%. To formula ② discriminant endoscopic gastrointestinal cancer sensitivity was 90.0%, specificity was 92.5%. Conclusion The apparatus can assist the endoscopist to judge the pathological changes in real time and noninvasively. The new fluorescence biopsy guider in discriminating benign and malignant lesions of the gastrointestinal tract on the effectiveness and OMA widely used in the world, the cost of the instrument is equivalent to purchase one tenth of the OMA testing equipment