电子喉镜在咽喉部肿物活检中的临床应用及病理分析  

Clinical application of electronic laryngoscope in biopsy of throat and pathological analysis

作　　者：林川耀[1] 陆玲[1] 张标[2] 张思思 刘丁丁[1] 高下[1] Chuan-yao Lin;Ling Lu;Biao Zhang;Si-si Zhang;Ding-ding Liu;Xia Gao(Department of Otolaryngology Head and Neck Surgery(Research Institute of Otolaryngology),Drum Tower Hospital affiliated to Nanjing University Medical School,Nanjing,Jiangsu 210008,China;Department of Pathology,Drum Tower Hospital affiliated to Nanjing University Medical School,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科(南京鼓楼医院耳鼻咽喉研究所),江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《中国内镜杂志》2018年第9期1-6,共6页China Journal of Endoscopy

基　　金：国家自然科学基金青年基金项目(No:81700913);江苏省科教强卫工程江苏省重点学科(No:ZDKB2016015);江苏省科教强卫工程江苏省青年医学人才(No:QNRC2016002)

摘　　要：目的探讨电子喉镜下对咽喉部肿物活检的临床应用,并分析病理结果。方法回顾性分析声带白斑、喉部肿瘤、下咽部肿瘤3类咽喉部常见肿物的患者资料共199例,均在门诊电子喉镜下表面麻醉后进行组织活检,送病理检查。分析3类病变患者的性别、年龄分布及病理意义。评价电子喉镜下活检咽喉部肿物的价值和意义。结果 3类病变的男性患者均明显多于女性,声带白斑患者年龄段分布明显比喉部和下咽部肿瘤患者年轻化(P<0.05)。67例声带白斑病理:慢性炎伴鳞状上皮增生35例(52.24%),低度上皮内瘤变17例(25.37%),高度上皮内瘤变12例(17.91%),可疑浸润癌2例(2.99%),浸润癌1例(1.49%)。97例喉部肿瘤病理:高度上皮内瘤变/原位癌35例(36.08%),可疑浸润癌14例(14.43%),浸润癌48例(49.48%)。35例下咽部肿瘤病理:高度上皮内瘤变/原位癌6例(17.14%,),可疑浸润癌4例(11.43%),浸润癌25例(71.43%)。结论电子喉镜下表面麻醉活检咽喉部肿物,麻醉风险低,操作灵活,明显减少了患者经济成本,为后续治疗提供了病理学依据,是方便、快捷、有效的活检方法。Objective To explore the clinical application of electronic laryngoscopy for the biopsy of throat tissue and analyze the pathological results.Methods A retrospective analysis of 199 cases with vocal leukoplakia,laryngeal neoplasms,and hypopharyngeal neoplasms were performed under electronic laryngoscopy.Tissue biopsy was performed after surface anesthesia by electronic laryngoscopy,and pathological examinations were performed.The gender,age distribution,and pathological significance of the three diseases were analyzed.Then evaluate the value and significance of biopsy throat masses under electronic laryngoscopy.Results There were significantly more males than females in the three types of disease.The age distribution of patients with vocal fold leukoplakia was significantly younger than that of the laryngeal and hypopharyngeal neoplasms(P<0.05).Pathological results of vocal cord leukoplakia in 67 cases:35 cases(52.24%)with chronic inflammatory squamous epithelial hyperplasia,17 cases(25.37%)with low grade intraepithelial neoplasia,and 12 cases(17.91%)with high grade intraepithelial neoplasia,suspicious infiltrating carcinoma 2 cases(2.99%),one case of invasive carcinoma(1.49%).The pathological results of 97 cases of laryngeal neoplasms were:35 cases(36.08%)with high grade intraepithelial neoplasia/in situ carcinoma,14 cases(14.43%)with suspicious invasive carcinoma,and 48 cases(49.48%)with invasive carcinoma.Pathological findings of 35 cases of hypopharyngeal neoplasms:6 cases(17.14%)with high grade intraepithelial neoplasia/in situ carcinoma,4 cases(11.43%)with suspected invasive carcinoma,and 25 cases(71.43%)with invasive carcinoma.Conclusions The electronic laryngoscope underwent surface anesthesia for biopsy of throat,low risk of anesthesia,and flexible operation,which significantly reduced the economic cost of the patient and provided a pathological basis for follow-up treatment.It is a convenient,rapid,and effective biopsy method.

关 键 词：电子喉镜 声带白斑 咽喉部肿瘤 活检 病理 

分 类 号：R767.1[医药卫生—耳鼻咽喉科] R766.5[医药卫生—临床医学]