目的分析自发性荧光电子支气管镜(AFB)与普通白光电子支气管镜(WLB)用于中心型肺癌患者气管、支气管检查的结果,比较两者的敏感性和准确性。方法 2009年9月至2010年5月北京大学人民医院共为46例中心型肺癌患者同时进行了AFB和WLB检查,其中男36例,女10例;平均年龄62.1岁。初诊患者35例,术后复查11例。采用声门和气道局部麻醉+静脉持续药物维持的无痛性气管镜技术,经口置入电子支气管镜,先在普通白光下检查全部气道,再切换至荧光状态对气道重新检查,分别对每一处可疑病变部位进行活组织病理检查。结果全组患者手术顺利,无死亡和严重并发症发生。46例患者共进行电子气管镜检查48次,共取活组织检查159处,均获得明确病理诊断,包括恶性病变64处,良性病变95处。64处恶性病变中,AFB无漏诊;WLB漏诊15处,漏诊率23.4%。初诊35例共进行36次检查,共发现56处恶性病变,AFB无漏诊;WLB共漏诊12处,其中AFB发现6例患者肿瘤范围超过WLB;AFB发现3例患者气道内多发癌变,而WLB检查漏诊;26例患者AFB和WLB检查结果相符。术后复查11例共进行12次检查,共发现8处恶性病变,AFB无漏诊;WLB漏诊3处,为2例肺癌术后早期黏膜复发或再发患者。AFB和WLB在中心型肺癌患者气道检查中的诊断敏感性分别为100.0%和76.6%(P<0.001),阴性预测值分别为100.0%和84.5%(P=0.002)。结论 AFB应用于中心型肺癌患者的气道检查,敏感性和阴性预测值显著优于WLB。它可以更准确地判断气道内肿瘤侵犯范围,更灵敏地发现气道内多发病变,更敏感地发现气道内复发病变。 Objective To analyze the results of tracheal and bronchial examination of patients with central lung cancer by spontaneous fluorescence electron bronchoscope (AFB) and plain white electron bronchoscope (WLB), and to compare the sensitivity and accuracy of the two. Methods From September 2009 to May 2010, 46 patients with central lung cancer underwent Peking University People’s Hospital at the same time were examined by AFB and WLB, including 36 males and 10 females; the average age was 62.1 years. 35 cases of newly diagnosed patients, postoperative review of 11 cases. The use of glottis and airway local anesthesia + intravenous sustained drug-free bronchoscopy, oral electronic bronchoscopy, the first general white light check all airways, and then switch to the fluorescence state of the airway re-examination, respectively Biopsy pathology was performed on every suspicious lesion. Results All patients underwent surgery successfully without death and serious complications. Forty-six patients underwent electron bronchoscopy for 48 times. A total of 159 biopsies were obtained, all of which were confirmed by pathological examination, including 64 malignant lesions and 95 benign lesions. Of 64 malignant lesions, AFB had no missed diagnosis; WLB missed 15 and missed diagnosis rate was 23.4%. A total of 56 lesions were detected in 35 newly diagnosed cases, and 56 malignant lesions were found. No missed diagnosis was found in AFB. 12 missed WLBs, of which 6 were found to have tumors that exceeded WLB in AFB. 3 patients had multiple carcinomas in AFB, Misdiagnosis; 26 patients with AFB and WLB test results. Eleven patients underwent a total of 12 examinations after operation. Eight malignant lesions were found and no missed diagnosis was found in the AFB. Three missed WLB missed the early postoperative mucosal resection or recurrence in patients with lung cancer. The diagnostic sensitivity of AFB and WLB in airway examination of patients with central lung cancer were 100.0% and 76.6%, respectively (P <0.001), with negative predictive values ​​of 100.0% and 84.5%, respectively (P = 0.002). Conclusions AFB is used for airway examination in patients with central lung cancer. Sensitivity and negative predictive values ​​are significantly better than WLB. It can more accurately determine the extent of tumor invasion within the airway, more sensitive to find multiple lesions in the airway, more sensitive to detect airway recurrence lesions.