中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2010年
2期
143-147
,共5页
倪晓光%贺舜%徐震纲%吕宁%高黎%袁峥%张月明%赖少清%易俊林%王晓雷%张蕾%李晓燕%王贵齐
倪曉光%賀舜%徐震綱%呂寧%高黎%袁崢%張月明%賴少清%易俊林%王曉雷%張蕾%李曉燕%王貴齊
예효광%하순%서진강%려저%고려%원쟁%장월명%뢰소청%역준림%왕효뢰%장뢰%리효연%왕귀제
诊断显像%喉肿瘤%早期诊断%喉镜检查
診斷顯像%喉腫瘤%早期診斷%喉鏡檢查
진단현상%후종류%조기진단%후경검사
Diagnostic imaging%Laryngeal neoplasms%Early diagnosis%Laryngoscopy
目的 探讨窄带成像(narrow band imaging,NBI)内镜在喉癌及其癌前病变诊断中的应用价值.方法 自2008年12月至2009年7月对122例怀疑有喉癌或癌前病变的患者选用具有普通白光和NBI两种观察模式的电子内镜进行咽喉部的检查.对发现的病灶依次使用白光和NBI模式进行分类和病灶性质的判断,以病理诊断作为金标准,比较两种观察模式对喉癌的诊断作用.结果 122例患者中共发现了149个病灶,其中息肉16个,炎性反应7个,单纯性增生24个,轻度不典型增生17个,中度不典型增生6个,重度不典型增生6个,原位癌9个,浸润癌64个.NBI内镜对喉部病变的正确诊断率是90.6%(135/149),高于普通白光内镜的75.2%(112/149),两者比较差异有统计学意义(x~2=12.514,P<0.001).NBI内镜对喉癌诊断的敏感性为93.2%(68/73),高于普通白光内镜的68.5%(50/73,x~2=14.317,P<0.001).结论 NBI内镜通过识别黏膜表面微细血管形态变化提高对喉癌诊断的敏感性和喉部病变诊断的正确率,从而增强内镜在喉癌术前诊断和术后随访中的作用.
目的 探討窄帶成像(narrow band imaging,NBI)內鏡在喉癌及其癌前病變診斷中的應用價值.方法 自2008年12月至2009年7月對122例懷疑有喉癌或癌前病變的患者選用具有普通白光和NBI兩種觀察模式的電子內鏡進行嚥喉部的檢查.對髮現的病竈依次使用白光和NBI模式進行分類和病竈性質的判斷,以病理診斷作為金標準,比較兩種觀察模式對喉癌的診斷作用.結果 122例患者中共髮現瞭149箇病竈,其中息肉16箇,炎性反應7箇,單純性增生24箇,輕度不典型增生17箇,中度不典型增生6箇,重度不典型增生6箇,原位癌9箇,浸潤癌64箇.NBI內鏡對喉部病變的正確診斷率是90.6%(135/149),高于普通白光內鏡的75.2%(112/149),兩者比較差異有統計學意義(x~2=12.514,P<0.001).NBI內鏡對喉癌診斷的敏感性為93.2%(68/73),高于普通白光內鏡的68.5%(50/73,x~2=14.317,P<0.001).結論 NBI內鏡通過識彆黏膜錶麵微細血管形態變化提高對喉癌診斷的敏感性和喉部病變診斷的正確率,從而增彊內鏡在喉癌術前診斷和術後隨訪中的作用.
목적 탐토착대성상(narrow band imaging,NBI)내경재후암급기암전병변진단중적응용개치.방법 자2008년12월지2009년7월대122례부의유후암혹암전병변적환자선용구유보통백광화NBI량충관찰모식적전자내경진행인후부적검사.대발현적병조의차사용백광화NBI모식진행분류화병조성질적판단,이병리진단작위금표준,비교량충관찰모식대후암적진단작용.결과 122례환자중공발현료149개병조,기중식육16개,염성반응7개,단순성증생24개,경도불전형증생17개,중도불전형증생6개,중도불전형증생6개,원위암9개,침윤암64개.NBI내경대후부병변적정학진단솔시90.6%(135/149),고우보통백광내경적75.2%(112/149),량자비교차이유통계학의의(x~2=12.514,P<0.001).NBI내경대후암진단적민감성위93.2%(68/73),고우보통백광내경적68.5%(50/73,x~2=14.317,P<0.001).결론 NBI내경통과식별점막표면미세혈관형태변화제고대후암진단적민감성화후부병변진단적정학솔,종이증강내경재후암술전진단화술후수방중적작용.
Objective To investigate the value of narrow band imaging (NBI) endoscopy in the detection of laryngeal cancer and its precursor lesions.Methods Between December 2008 and July 2009, a total of 122 consecutive patients with suspected precancerous or cancerous lesions of the larynx were enrolled in this study.High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of larynx.Full pharyngeal and laryngeal examination was performed first under white light endoscope and then under NBI. Each lesion was observed by NBI endoscopy and classified according to the detailed morphologic findings of epithelial microvessels. Histological results were then compared to the corresponding white light and NBI images.Results Among the 122 patients, a total of 149 lesions were detected by white light and NBI modes.The histological diagnoses of these lesions were as follows:16 laryngeal polyp, 7 laryngitis, 24 simple hyperplasia, 17 mild dysplasia, 6 moderate dysplasia, 6 severe dysplasia, 9 carcinoma in situ, 64 invasive cancer. The diagnostic accuracy by NBI for the laryngeal lesions was 90.6% (135/149), which was significantly higher than that of white light (75.2%, 112/149, X~2 = 12.514,P <0.001).The sensitivity of NBI and white light to detect laryngeal carcinoma was 93.2% (68/73) and 68.5% (50/73), respectively (X~2 = 14.317, P < 0.001).Conclusions NBI endoscopy was a promising tool for the differentiation of non-malignant from malignant laryngeal lesions in vivo by detection of the morphology of mucosal capillary vessels.NBI endoscopy was easy to application in the routine pharyngolaryngeal examination with high sensitivity, and facilitated to improve the abilities of preoperative diagnosis and postoperative surveillance.
