电子喉镜检查与窄带成像技术在声带白斑诊断中的应用  

Application of electronic laryngoscopy and narrow band imaging technique in the diagnosis of vocal cord leukoplakia

作　　者：张思思 刘晶[1,2] 林川耀 陆玲[1,2] 钱晓云 ZHANG Sisi;LIU Jing;LIN Chuanyao;LU Ling;QIAN Xiaoyun(Department of Otolaryngology Head and Neck Surgery,Nanjing Drum Tower Hospital,the affiliated Hospital of Nanjing University Medical School,Jiangsu Provincial Key Medical Discipline Laboratory,Nanjing,Jiangsu,210008,China;Research Institute of Otolaryngology,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,江苏省医学重点学科,江苏南京210008 [2]南京鼓楼医院耳鼻咽喉研究所,江苏南京210008

出　　处：《中国耳鼻咽喉头颈外科》2021年第10期643-646,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：江苏省科教强卫工程项目江苏省重点学科(ZDXKB2016015),南京市卫生青年人才培养工程(第一层次)(QRX17012),国家自然科学基金(82071059)。

摘　　要：目的探讨术前应用电子喉镜检查及窄带成像(narrow band imaging,NBI)技术对声带白斑形态学分型与病理组织诊断之间的相关性,为治疗方案提供依据。方法回顾性分析南京大学医学院附属鼓楼医院2017年1月~2019年12月接受支撑喉镜下CO2激光治疗203例声带白斑患者临床资料。将电子喉镜下形态学分型、NBI分型与其对应的病理组织诊断进行分析比较。应用受试者工作特征曲线(receiver operator characteristic,ROC)来判断不同检查方法诊断声带白斑的准确性。结果电子喉镜下形态学分型、NBI分型与病理组织诊断均存在相关性(r_(s)分别为0.415、0.255,P均<0.05),且均有统计学意义(χ2分别为39.054、103.440,P均<0.05)。NBI分型与电子喉镜下形态学分型的曲线下面积分别为0.863和0.678。结论电子喉镜下形态学分型和NBI分型对声带白斑良恶性鉴别诊断均具有较强识别能力,且NBI分型对于诊断声带白斑比电子喉镜下形态学分型更有价值。OBJECTIVE To investigate the correlation between the morphology and histological diagnosis of vocal cord leukoplakia by using electronic laryngoscopy and narrow band imaging(NBI)technique before surgery.To provide a basis for the reasonable treatment plan.METHODS The clinical data of 203 patients with vocal cord leukoplakia who received minimally invasive surgery with carbon dioxide laser in our hospital from January 2017 to December 2019 were retrospectively analyzed.The morphological classification of vocal cord leukoplakia under electronic laryngoscopy,and the classification under NBI were analyzed and compared with corresponding pathological results.Receiver operator characteristic(ROC)was used to determine the accuracy of different examination methods in diagnosis of the vocal cord leukoplakia.RESULTS The morphological classification of vocal cord leukoplakia under electronic laryngoscopy was correlated with pathological tissue results(r_(s)=0.415,P<0.05),and the difference was statistically significant(χ2=39.054,P<0.05).There was a correlation between NBI classification and pathological tissue results(r_(s)=0.255,P<0.05),and the difference was statistically significant(χ2=103.440,P<0.05).The areas under the curves of the classification under NBI and morphology were 0.863 and 0.678.CONCLUSION The morphological classification of vocal cord leukoplakia under electronic laryngoscopy and the classification of NBI have strong recognition ability for the diagnosis of benign and malignant lesions.NBI is more valuable for the diagnosis of vocal cord leukoplakia than morphology under electronic laryngoscopy.

关 键 词：声带 白斑 喉镜检查 诊断 窄带成像 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]