CN85100424B - 恶性肿瘤固有荧光诊断仪 - Google Patents

恶性肿瘤固有荧光诊断仪 Download PDF

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CN85100424B
CN85100424B CN85100424A CN85100424A CN85100424B CN 85100424 B CN85100424 B CN 85100424B CN 85100424 A CN85100424 A CN 85100424A CN 85100424 A CN85100424 A CN 85100424A CN 85100424 B CN85100424 B CN 85100424B
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曾堃
朱九德
吴金荣
杨森
曹九如
虞震芬
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SHANGHAI CHANGNING DISTRICT CENTRAL HOSPITAL
SHANGHAI RESEARCH INST OF MEDICAL APPARATUS AND INSTRUMENT
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Abstract

一种恶性肿瘤固有荧光诊断仪，属于医用诊断仪器。可快速、简便、正确、无损伤地诊断恶性肿瘤。紫外光由石英光导纤维传输到活体组织表面，激发其固有荧光，並由普通光导纤维接受和传输固有荧光，经光学和电路处理，显示记录光谱曲线，分析曲线是否存在恶性肿瘤特征峰即可确诊活体组织是否存在恶性肿瘤。也可用目测法观察活体组织固有荧光，根据其色泽诊断恶性肿瘤。可用于临床诊断体表及体内凡光导纤维可触及部位的恶性肿瘤，符合率达９０％以上。

Description

恶性肿瘤固有荧光诊断仪
本发明属于医用诊断仪器。
在已有技术中，日本筑波大学蔡·承熹在《日本消化器内视镜学会杂志》Vol（26）8Aug1984的一篇论文“激光激发消化系统荧光光谱分析及荧光物质初探的研究”中，述及他使用波长为5145
Figure 85100424_IMG7
的氩离子激光器作为激发光源，通过光导纤维照射被测离体标本，标本受激后产生的固有荧光反射入光信号处理系统，经处理后得到离体标本的固有荧光光谱，并且在显示记录系统上加以显示和记录，通过分析固有荧光光谱图来诊断标本是否存在恶性肿瘤，也可不用光信号处理系统和显示记录系统而直接用肉眼在垂直于离体标本表面的方向直接观察固有荧光的色泽以判断癌症的存在与否。蔡·承熹的诊断方法的符合率较低，例如，对于大肠癌只有30%的符合率，这是因为已有技术中氩离子激光器发射的蓝绿色可见光迭加在由它激发的离体标本的属于可见光波段的固有荧光光谱上，因此导致错误的实验结论，影响诊断的正确性，并且他的工作尚停留在实验室阶段，仅作了离体标本的研究，还没有一台完整的恶性肿瘤诊断仪器以供活体组织临床诊断仪。
本发明旨在解决已有技术中这一问题，并克服光源能量弱从而诊断灵敏度低的缺点，特别是希望研制出一台能快速、简便、正确且无创伤地用于人体临床诊断各种肿瘤的仪器，以造福广大人民群众。
本发明是对激发固有荧光的光源及光的传输系统作改进而完成的，其中，对光源系统的改进是选用波长为3000～4000的近紫外光源作为激发光源，激发光能量大大增加，并且光源的发射波长与恶性肿瘤组织的吸收峰值3400
Figure 85100424_IMG9
±200
Figure 85100424_IMG10
接近，故其灵敏度高，从而诊断符合率也就高，更为重要的是，光源发射的近紫外波段是不可见光，而光源激发的固有荧光是可见光，故由近紫外光源激发的固有荧光光谱为不与光源光谱相迭加的单纯的活体组织本身的特征光谱，所以采用近紫外光源的恶性肿瘤固有荧光诊断仪诊断恶性肿瘤的符合率很高。它能够诊断出粘膜或粘膜下层1～2mm厚度的恶性肿瘤，对于早期诊断意义重大。
此外，光的传输系统中，不仅采用了柔软的光导纤维传输激发光，并用光导纤维接受和传输活体组织上反射的固有荧光，因而，本仪器不仅能诊断人体体表的恶性肿瘤，而且还能诊断内窥镜能得到的人体体腔内部的恶性肿瘤以及在手述过程中暴露于视野内的恶性肿瘤，用以指导医师确定肿瘤的部位及范围。由于激发光是近紫外光，故传输激发光所采用的光导纤维必须是能适用于紫外光的石英光导纤维，本仪器中，用低损耗石英光导纤维传输激发光，至于接受并传输固有荧光的光导纤维，则可采用价格远低于石英光导纤维且易于加工的普通光导纤维，因为活体组织的固有荧光在可见光波段，另外为了增加接受面积，以增加接受到的荧光强度，在本仪器中使用的普通光导纤维采用多股形式。
此仪器由于快速、无损、操作简便，符合率高，可广泛用于恶性肿瘤的临床诊断和普查。
上海长宁区中心医院、上海市肿瘤医院、上海第一医学院附属妇产科医院等大家医院使用此仪器对406例各种恶性肿瘤患者作了验证，其符合率达90%以上。
图1是恶性肿瘤固有荧光诊断仪结构示意图。
图2是正常活体组织的固有荧光光谱图。
图3是存在恶性肿瘤的活体组织的固有荧光光谱图。
图4是本实施例的光源系统及光传输系统示意图。
下面是本发明的一个最佳实施例。
在本实施例中，如图4所示用汞灯〔10〕及反光碗〔11〕固定在一个可调节支架〔12〕上，反光碗〔11〕将汞灯〔10〕发射的光通过调节支架〔12〕聚焦于4-12片每片厚度为1-2mm的迭加在一起的紫外光滤色片组〔13〕的中心，经过滤色片组〔13〕成为单色性极佳的3650
Figure 85100424_IMG11
的激发光与最佳工作波段3400±200
Figure 85100424_IMG13
甚为接近。
传输激发光的光导纤维〔2〕由低损耗的多股石英光导纤维组成，它将激发光传输到活体组织〔3〕的表面。传输固有荧光的光导纤维〔4〕由多股普通光导纤维组成，它的输入端与活体组织〔3〕表面垂直，并与传输激发光的光导纤维〔2〕的输出端在固定架〔15〕内固定成45°夹角。一个与固定架〔15〕形状，大小近似的外罩〔16〕紧密地罩在固定架〔15〕的外面，（图4中用虚线表示）它控制传输激发光的光导纤维〔2〕的输出端和传输固有荧光的光导纤维〔4〕的输入端与被测组织表面相距2-10mm。使用时，外罩〔16〕下端紧贴被测组织表面，每使用一次，调换一只外罩，以免仪器多次接触活体组织引起的交叉感染。
如图1所示由光源系统〔1〕出射的波长为3000
Figure 85100424_IMG14
-4000
Figure 85100424_IMG15
的近紫外光通过低损耗石英光导纤维传输到被测的活体组织〔3〕的表面，激发活体组织，包括正常组织和恶性肿瘤的特征光谱而呈现固有荧光，反射的固有荧光由多股普通玻璃光导纤维传输到分色系统〔5〕，经过0.5秒自动扫描系统〔8〕扫描及经过电路系统〔6〕处理，0.5秒内即能由数字显示报警系统数字显示和报警，并由显示记录系统作固有荧光光谱的显示记录，得到被测活体组织固有荧光光谱图。如图2和图3所示，若被测组织〔3〕是正常组织，则其固有荧光光谱图如图2所示，只有一个峰，在4500
Figure 85100424_IMG16
-4800
Figure 85100424_IMG17
的蓝色波段范围，若被测活体组织〔3〕含恶性肿瘤，仪器同时作数字显示和报警。
本实施例用汞灯作紫外光源，它比其他紫外光源结构简单、操作维修方便，价格低廉，故便于推广应用。
作为本实施例的一个变换，也可用紫外激光器做光源，它发射的激光注入传输激发光的光导纤维〔2〕的输入端，被传输到活体组织〔3〕表面，激发其固有荧光。用紫外激光器做光源代替汞灯做光源的光源系统，其优点在于它发射能量大，激发固有荧光的效率就高，因而对于处理固有荧光的电路系统要求降低。但紫外激光器的价格远大于汞灯。所以固有荧光诊断仪采用何种光源应视需要和可能而定。紫外激光器可以采用氮激光器、氪激光器、氙激光器或准分子激光器。
作为本实施例的又一种变换，传输激发光的光导纤维〔2〕的输出端和传输固有荧光的光导纤维〔4〕的输入端可以做成同轴式结构，从而减小光导纤维与活体组织的接触面和减小光导纤维所占空间，以利于配合内窥镜作深入体内的诊断。其同轴的长度由被测部位在体腔内的深度而定。
同轴式光导纤维的结构中，传输激发光的光导纤维〔2〕由低损耗石英玻璃制成，传输活体组织固有荧光的光导纤维〔4〕由普通光学玻璃制成。同轴的方式可以是轴心为传输激发光的光导纤维〔2〕，它由多股的或直径为300μ-600μ的单股光导纤维制成，周围均布多股传输固有荧光的光导纤维〔4〕，或者是轴心为传输固有荧光的光导纤维〔4〕，周围均布多股传输激发光的光导纤维〔2〕。另外，也可以是多股传输固有荧光的光导纤维〔4〕和多股传输激发光的光导纤维〔2〕交叉排列成同轴复合光导纤维。但同轴式结构的光导纤维传输光的效果小于不同轴的光导纤维。故是否采用同轴式结构及采用何种同轴式结构应根据需要亦即根据所需探测的部位决定。
作为本实施例的又一变换，诊断恶性肿瘤可以不用上述的显示记录活体组织固有荧光光谱的波谱法，而改用肉眼直接观察活体组织受激发射的固有荧光色泽的目测法，正常活体组织的固有荧光光谱在4500
Figure 85100424_IMG18
-4800
Figure 85100424_IMG19
的蓝色波段范围内，而恶性肿瘤组织的固有荧光光谱在6000
Figure 85100424_IMG20
-6900
Figure 85100424_IMG21
的红色波段范围内，当目测到固有荧光光谱带有红色则立即可断定发射该荧光光谱的活体组织内有恶性肿瘤。

Claims (10)

1、一种属于医用诊断仪器的恶性肿瘤固有荧光诊断仪，它包括光源系统〔1〕，传输光的光导纤维，光信号处理系统和显示记录系统〔7〕，其特征在于，所述的光源系统〔1〕是激发波长范围在3000
Figure 85100424_IMG1
4000
Figure 85100424_IMG2
的近紫外的光源系统，所述的传输光的光导纤维包括传输激发光的低损耗石英光导纤维〔2〕和接收并传输活体组织上反射的固有荧光的多股普通光导纤维〔4〕。
2、按权利要求1所述的固有荧光诊断仪，其特征在于，所述的传输固有荧光的多股普通光导纤维〔4〕的输入端与活体组织表面垂直，并且与传输激发光的低损耗石英光导纤维〔2〕的输出端在固定架〔15〕内固定成45°夹角，并且所述两个端部与活体组织〔3〕表面的距离由固定架〔15〕的外罩〔16〕控制在2-10mm。
3、按权利要求1所述的固有荧光诊断仪，其特征在于，所述的传输激发光的低损耗石英光导纤维〔2〕的输出端和传输同有荧光的多股普通光导纤维〔4〕的输入端做成同轴结构，同轴的方式是轴心为传输激发光的光导纤维，它由多股的或直径为300μ-600μ的单股光导纤维〔2〕制成，周围均布传输固有荧光的光导纤维〔4〕，或者是轴心为传输固有荧光的光导纤维〔4〕，周围均布多股传输激发光的光导纤维〔2〕，或者是多股传输固有荧光的光导纤维〔4〕和多股传输激发光的光导纤维〔2〕交叉排列成同轴复合光导纤维，同轴的长度视被测部位在体腔内的深度而定。
4、按权利要求1所述的固有荧光诊断仪，其特征在于，光源系统〔1〕包括汞灯〔10〕，反光碗〔11〕，固定于框架〔14〕上的滤色片组〔13〕以及用于固定汞灯〔10〕和反光碗〔11〕，并能调节汞灯〔10〕和反光碗〔11〕相对于滤色片组距离，以将反光碗〔11〕所反射的汞灯〔10〕发射的光聚焦于滤色片组〔13〕中心的调节支架〔2〕。
5、按权利要求4所述的固有荧光诊断仪，其特征在于，滤色片组〔13〕是由4-12片1-2mm厚的紫外光滤色片迭加在一起组成的。
6、按权利要求1所述的固有荧光诊断仪，其特征在于，光源系统是一个紫外激光器，它可以是氮激光器，氪激光器，氙激光器或准分子激光器。
7、按权利要求1、2、4、5或6所述的固有荧光诊断仪，其特征在于，光源系统最佳工作波长为3400
Figure 85100424_IMG3
±200
Figure 85100424_IMG4
。
8、按权利要求1、2、3、4、5或6所述的固有荧光诊断仪，其特征在于，所述的光信号处理系统包括分色系统〔5〕，电路系统〔6〕和0.5秒自动扫描系统〔8〕。
9、按权利要求1、2、3、4、5或6所述的固有荧光诊断仪，其特征在于，所述的显示记录系统〔7〕还配置数字显示报警系统〔9〕。
10、一种属于医用诊断仪器的恶性肿瘤固有荧光诊断仪，它包括光源系统和传输光的光导纤维，其特征在于，所述的光源系统是激发波长范围在3000
Figure 85100424_IMG5
-4000
Figure 85100424_IMG6
的近紫外的光源系统，所述的传输光的光导纤维是低损耗石英光导纤维，用肉眼直接观察活体组织受激发射的固有荧光色泽。
CN85100424A 1985-04-01 1985-04-01 恶性肿瘤固有荧光诊断仪 Expired CN85100424B (zh)

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JP61074108A JPS62270132A (ja) 1985-04-01 1986-03-31 悪性腫瘍の内因性螢光に対する診断装置
US07/212,630 US4957114A (en) 1985-04-01 1988-06-28 Diagnostic apparatus for intrinsic fluorescence of malignant tumor

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