窄带成像技术在诊断早期喉癌及癌前病变中的应用研究  

Application of endoscopic narrow band imaging in the diagnosis of early laryngeal cancer and the precancerous lesions

作　　者：李慧[1] 孙安池 张瑞静 王梦君 王晓敏[1] 张明洁[1] 马士崟[1] LI Hui;SUN Anchi;ZHANG Ruijing;WANG Mengjun;WANG Xiaomin;ZHANG Mingjie;MA Shiyin(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,233004,China)

机构地区：[1]蚌埠医学院第一附属医院耳鼻咽喉头颈外科,安徽蚌埠233004

出　　处：《中国耳鼻咽喉头颈外科》2022年第11期684-687,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：安徽省高校自然科学研究项目(KJ2021A0751);安徽省高校自然科学研究项目(KJ2021A0753)。

摘　　要：目的 探讨窄带成像(narrow band imaging,NBI)技术在诊断早期喉癌病变中的临床应用。方法 选取2019年1月~2020年12月蚌埠医学院第一附属医院耳鼻咽喉头颈外科就诊怀疑喉部恶性肿瘤或癌前病变的129例患者,应用NBI内镜对可疑病灶进行检查,判断病变性质后行病理学检查,并与白光内镜的结果进行比较。结果 NBI内镜和白光内镜的准确率、敏感性、阴性预测值分别为96.12% vs 86.05%、97.37% vs 86.84%、81.25% vs 44.44%,差异有统计学意义;病变颜色方面比较,差异有统计学意义(χ^(2)=178.889,P<0.05);病变黏膜表面的微血管形态结构判别良恶性比较,差异有统计学意义(χ^(2)=135.502,P<0.05);判断病变范围方面比较,差异有统计学意义(χ^(2)=91.899,P<0.05)。结论 NBI内镜比白光内镜能更好的观察到病变黏膜表面细微结构变化,对发现早期喉癌及癌前病变的能力及诊断的准确性较高,利于确定活检部位、早期诊断并确定手术安全边界,可用于喉癌的无创筛查和早期诊断。OBJECTIVE To explore the application value of narrow band imaging(NBI) technology in the diagnosis of early laryngeal carcinoma.METHODS A total of 129 patients with suspected laryngeal malignant tumors or precancerous lesions from January 2019 to December 2020 in the Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Bengbu Medical College were included in this study.NBI technology under electronic laryngoscope was used to examine the suspicious lesions.According to the characteristic manifestations of NBI under laryngoscope,the nature of laryngeal masses was judged,and all masses were diagnosed pathologically.The benign and malignant judgments of laryngeal masses were compared with the pathological results based on the white light mode and NBI mode under the electronic laryngoscope.RESULTSComparison of the characteristics of NBI mode and white light mode:1.The accuracy,sensitivity,and negative predictive value of the NBI mode and the white light mode were 96.12% and 86.05%;97.37% and 86.84%;81.25% and 44.44%,the difference was statistically significant;2.The difference between the NBI mode and the white light mode in the color of the lesion was statistically significant(χ^(2)=178.889,P<0.05);the morphology and structure of the microvessel on the surface of the lesion mucosa was statistically significant difference between benign and malignant lesions(χ^(2)=135.502,P<0.05);the difference in judging the extent of lesions was statistically significant(χ^(2)=91.889,P<0.05).CONCLUSIONCompared with white light endoscopy,NBI technology can better observe the fine changes in the microstructure of the mucosal surface.Its ability to detect early laryngeal cancer and precancerous lesions and the accuracy of diagnosis are higher than that of white light laryngoscope,which is helpful to determining the biopsy site,early diagnosis and determining the safety margin of surgery.It can be used for screening and early diagnosis of laryngeal cancer.

关 键 词：喉肿瘤 诊断 窄带光成像 

分 类 号：R739.65[医药卫生—肿瘤]