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目的 研究激光诱发荧光 (LIF)技术在大肠癌早期诊断中的作用 ,并对LIF光谱产生的机制进行初步的探讨。方法 1.以氮分子激光器作为激发光源 ,采用OMAⅢ对体外 60例标本及体内 83例患者病变组织与正常组织的LIF光谱进行记录、分析。 2 .应用激光共聚焦扫描显微镜检测组织各层荧光强度。结果 1.根据体内、外LIF光谱的特点 ,选择主峰强度 (x1)、I 4 0 0nm/I 5 3 0nm(x2 )和集成荧光强度 ( 3 5 0～ 60 0nm) (x3 )三个参数 ,对已知病变求得判别方程 ,利用该方程对未知病变进行分析 ,体外诊断大肠癌的敏感性和特异性分别为 89.3 6%和 87.64 % ,体内为 83 .3 3 %和 94 .3 8% ,伴有中～重度不典型增生的腺瘤性息肉 87.10 % ,判别为异常。 2 .激光共聚焦扫描显微镜检测结果显示正常组织粘膜下层及肌层荧光较强 ,而正常组织粘膜层与癌组织的荧光均较弱 ;正常粘膜上皮脱落细胞与癌细胞可以产生荧光 ,但光谱强度均较弱。结论 1.LIF光谱可以在体内、外区别大肠癌组织与正常组织 ,尤其是对不典型增生的鉴别能力较强 ,提示该技术对于大肠癌的早期诊断具有非常重要的意义。 2 .正常组织LIF光谱的来源主要是胶原含量丰富的粘膜下层 ,而癌组织的光谱可能是癌细胞与间质共同作用的结果。
Objective To study the role of laser-induced fluorescence (LIF) technology in the early diagnosis of colorectal cancer, and to explore the mechanism of LIF spectra. Methods 1. The LIF spectra of lesions and normal tissues from 60 patients in vitro and 83 patients in vivo were recorded and analyzed using nitrogen molecular laser as excitation light source. 2. Use a laser confocal scanning microscope to detect the fluorescence intensity of each layer of the tissue. Results 1. According to the characteristics of LIF spectra in vivo and in vitro, the main peak intensities (x1), I400nm/I503nm (x2) and integrated fluorescence intensity (350-600nm) (x3) were selected. Discriminant equations were obtained for known lesions. The sensitivity and specificity of this equation for the diagnosis of colorectal cancer were 89.36% and 87.64%, and 83.33% and 94.38% in vivo, respectively. , with moderate to severe dysplasia of adenoma polyps 87.10 %, identified as abnormal. 2. The results of confocal laser scanning microscopy showed that the fluorescence in normal submucosa and myometrium was strong, while the fluorescence in normal mucosa and cancer tissue was weak; normal epithelium exfoliated cells and cancer cells could produce fluorescence, but the spectral intensity Both are weaker. Conclusions 1. LIF spectroscopy can distinguish between colorectal cancer tissue and normal tissues in vivo and in vitro, especially in the differential diagnosis of atypical hyperplasia, suggesting that this technique is of great significance for the early diagnosis of colorectal cancer. 2. The source of normal tissue LIF spectra is mainly the submucosa with abundant collagen content, and the spectrum of cancer tissue may be the result of the joint action of cancer cells and interstitium.