论文部分内容阅读
目的 :研究体内不同分化程度胃癌的自发荧光光谱表现特征,初步探索提高自发荧光光谱诊断准确性的方法。方法:纳入2010年1月至12月我院88例患者,均接受了普通胃镜检查和激光诱发自发荧光光谱检测,其中内镜病理诊断为胃癌者73例,慢性胃炎者15例。在400~700 nm间每隔50 nm测定1个荧光样本。病灶和邻近组织正常黏膜分别取活组织检查(活检),病理提示胃癌的患者进行外科手术治疗。胃癌患者根据分化程度分组,比较不同病理类型胃癌的自发荧光值差异。结果:73例胃癌患者根据胃癌分化程度分成3组,高分化胃癌组(H组)32例,中分化胃癌组(M组)16例,低分化胃癌组(L组)25例。15例慢性胃炎患者均为慢性萎缩性胃炎,为良性胃炎组。在450~550 nm波段,荧光强度与胃癌分化程度呈正相关(r450 nm=0.653,P<0.01;r500 nm=0.712,P<0.01;r550 nm=0.455,P<0.01),H组和M组分别与良性胃炎组比较,其荧光强度均存在显著差异(均P<0.05)。而L组荧光强度只在450~500 nm波段内与良性胃炎组存在显著差异(P<0.05)。讨论:波长450~500 nm有可能是检测低分化胃癌的自发荧光采集波段,可为提高自发荧光诊断胃癌的准确率提供参考。
Objective: To study the characteristics of spontaneous fluorescence spectra of gastric cancer with different degrees of differentiation in vivo and to explore ways to improve the diagnostic accuracy of autofluorescence spectroscopy. Methods: A total of 88 patients admitted to our hospital from January to December 2010 were enrolled in the routine gastroscopy and laser induced autofluorescence assay. Among them, 73 were diagnosed as gastric cancer by endoscopy and 15 by chronic gastritis. One fluorescence sample was measured every 50 nm between 400 and 700 nm. Lesions and adjacent normal tissue mucosa were taken biopsy (biopsy), pathology prompted gastric cancer patients for surgical treatment. Gastric cancer patients were divided into groups based on the degree of differentiation, compared with different pathological types of gastric cancer spontaneous fluorescence value differences. Results: 73 cases of gastric cancer were divided into 3 groups according to the degree of gastric cancer differentiation, 32 cases of well-differentiated gastric cancer group (H group), 16 cases of moderately-differentiated gastric cancer group (M group) and 25 cases of poorly differentiated gastric cancer group (L group). 15 cases of chronic gastritis patients are chronic atrophic gastritis, benign gastritis group. In the 450-550 nm band, the fluorescence intensity was positively correlated with the differentiation of gastric cancer (r450 nm = 0.653, P <0.01; r500 nm = 0.712, P <0.01; r550 nm = 0.455, P <0.01) Compared with the benign gastritis group, the fluorescence intensity was significantly different (all P <0.05). However, the fluorescence intensity in L group was significantly different from that in benign gastritis only in the band of 450-500 nm (P <0.05). Discussion: The wavelength of 450-500 nm may be the detection of poorly differentiated gastric cancer autofluorescence acquisition band, which can provide a reference for improving the accuracy of autofluorescence in the diagnosis of gastric cancer.