智能分光比色技术在喉白斑诊断中的应用价值分析  

Diagnostic value of Fuji intelligent chromo endoscopy in leukoplakia of the larynx

作　　者：彭莉 邓安春 周雪琴 包小敏 Peng Li;Deng Anchun;Zhou Xueqin;Bao Xiaomin(Department of Otolaryngology,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院耳鼻咽喉科,重庆400037

出　　处：《中国医学前沿杂志（电子版）》2020年第3期161-164,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陆军军医大学校级课题资助项目(2018XLCO36)。

摘　　要：目的探讨智能分光比色技术(Fuji intelligent chromo endoscopy,FICE)对喉白斑的诊断价值。方法选取2017年3月至2018年10月于陆军军医大学第二附属医院行内镜检查的69例喉白斑患者为研究对象。所有患者先行普通白光内镜(white light endoscopy,WLE)模式检查,然后行FICE模式检查和病理组织学活检,重点观察FICE模式下的上皮乳头状微血管袢(intra-epithelial papillary capillary loop,IPCL)的分型情况。以病理组织学检查结果为"金标准",比较WLE与FICE两种模式的诊断效能,并比较不同病理组织学检查结果的IPCL分型差异。结果病理组织学检查结果显示,全部69例患者共35例(50.7%)恶性病变和34例(49.3%)非恶性病变(包括20例良性病变和14例癌前病变)。WLE和FICE两种模式对喉白斑恶性病变均具有一定的诊断效果,WLE、FICE模式的敏感度分别为86.7%和94.1%,特异度分别为76.9%和91.4%。FICE模式的诊断符合率为92.8%,显著高于WLE模式(81.2%)(P<0.05)。三种病理组织学检查结果的IPCL分型两两比较差异均有统计学意义(均P<0.05),Ⅰ型与Ⅱ型均为良性病变,癌前病变以Ⅲ型为主,恶性病变以Ⅴ型为主。结论FICE对喉白斑的良/恶性判断有重要参考价值,诊断价值优于普通WLE模式,其中IPCL分型与病理组织下检查结果明显相关,值得临床推广应用。Objective To investigate the diagnostic value of Fuji intelligent chromo endoscopy(FICE)in leukoplakia of the larynx.Method Sixty-nine patients with leukoplakia of the larynx who underwent endoscopy examination in the Second Affiliated Hospital of Army Medical University from March 2017 to October 2018 were enrolled for the study.All patients received conventional white light endoscopy(WLE),then FICE and pathological biopsy,and we focusing on the classification of intraepithelial papillary capillary loop(IPCL)under FICE mode.Base on the gold standard as pathological and histological result,the diagnostic efficacy of WLE and FICE mode was compared,and the IPCL classification was compared among patients with different histopathological results.Result According to the pathological result,there were 35 cases(50.7%)of malignant lesions and 34 cases of(49.3%)non-malignant lesions(including 20 benign lesions and 14 precancerous lesions)in all 69 patients.WLE and FICE mode had certain diagnostic effects on malignant lesions of laryngeal leukoplakia.The sensitivity and specificity of WLE and FICE modes were 86.7%and 94.1%,76.9%and 91.4%,respectively.The coincidence rate of FICE mode was 92.8%and significantly higher than 81.2%of WLE mode(P<0.05).There were statistically significant differences in IPCL classification among three histopathological results(all P<0.05),and typeⅠand typeⅡwere benign lesions,precancerous lesions were mainly typeⅢ,and malignant lesions were mainly typeⅤ.Conclusion FICE has important reference value in the diagnosis of laryngeal leukoplakia,and its diagnostic value is superior to the conventional WLE model.IPCL classification is significantly correlated with pathological result,which is worthy of clinical application.

关 键 词：智能分光比色技术 喉白斑 诊断 上皮乳头状微血管袢 

分 类 号：R767[医药卫生—耳鼻咽喉科]