窄带成像内镜在喉咽癌早期诊断中的应用  

The application of narrow band imaging endoscopy in the early diagnosis of hypopharyngeal carcinoma

作　　者：倪晓光[1] 贺舜[1] 高黎[2] 徐震纲[3] 吕宁[4] 袁峥[4] 张月明[1] 赖少清[1] 易俊林[2] 王晓雷[3] 张蕾[1] 李晓燕[1] 王贵齐[1] 

机构地区：[1]中国医学科学院肿瘤医院内镜科,北京100021 [2]中国医学科学院肿瘤医院放疗科,北京100021 [3]中国医学科学院肿瘤医院头颈外科,北京100021 [4]中国医学科学院肿瘤医院病理科,北京100021

出　　处：《中国耳鼻咽喉头颈外科》2009年第10期550-554,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京希望马拉松专项基金项目(LC2008A13);北京市科技新星计划(2007A105)联合资助

摘　　要：目的探讨喉咽癌内镜窄带成像(narrow band imaging,NBI)特点及NBI内镜在喉咽癌早期诊断中的应用价值。方法自2008年12月～2009年7月对46例喉咽癌患者使用具有普通白光和NBI两种观察模式的电子内镜进行咽喉部的检查。对发现的病灶分别评估白光模式和NBI模式下病变表面毛细血管形态和病变边界的清晰度,比较两种观察模式对喉咽癌的观察效果和病变的检出能力。结果在46例喉咽癌中共发现86个病灶,喉咽鳞状细胞癌在NBI内镜下表现为边界清楚的棕色区域,内部可见清晰的棕色斑点。在浅表型病灶中,NBI内镜在血管形态及病变边界的显示上都明显优于普通白光内镜(P<0.001),能够明显提高对重度不典型增生和原位癌的检出率(P<0.05)。结论NBI内镜能够通过清晰显示黏膜表面的微细血管形态和病变边界提高对早期喉咽癌的检出能力。OBJECTIVE To investigate the characteristics of hypopharyngeal carcinoma detected by narrow band imaging（NBI）endoscopy and evaluate the value of NBI in the early diagnosis of hypopharyngeal carcinoma. METHODS Between December 2008 and July 2009,a total of 46 consecutive patients with hypopharyngeal squamous cell carcinoma were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of pharynx and larynx. The quality of visualization of morphologies of epithelial capillary and demarcation line of each lesion under NBI view was evaluated in comparison with conventional white light endoscopy. RESULTS Among the 46 patients, a total of 86 lesions were detected. The notable characteristic of hypopharyngeal squamous cell carcinoma is the well demarcated brownish area and scattered brown dots. The NBI laryngoscope could provide better visualization of morphologies of epithelial capillary and demarcation line in superficial carcinoma of hypopharynx than the white light mode （P〈0.001） , the detection rate of severe dysplasia and carcinoma in situ can be improved by NBI compared with white light endoscopy （P〈0.05） . CONCLUSION NBI endoscopy may increase the detection abilities of early hypopharyngeal carcinoma by clearly visualization of the epithelial capillary and demarcation line.

关 键 词：内窥镜检查 下咽肿瘤 早期诊断 窄带成像技术 

分 类 号：R739.6[医药卫生—肿瘤]