胃镜结合窄带成像技术提高下咽及喉部病变检出率的研究  

A Study on Gastroscopy Combining with Narrow Band Imaging to Improve the Detection Rate of Hypopharyngeal and Laryngeal Lesions

作　　者：王菁[1] 邴雪 陈宇帆 黎建军[3] 徐国良[3] 林世永[3] WANG Jing;BING Xue;CHEN Yu-fan;LI Jian-jun;XU Guo-liang;LIN Shi-yong(Department of Gastroenterology,Nanfang Hospital,Southern Medical University,510515,Guangzhou,Guangdong;Department of Gastroenterology,People′s Hospital of Longhua District,Shenzhen City,518109,Shenzhen,Guangdong;Department of Endoscopy,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,510060,Guangzhou,Guangdong)

机构地区：[1]南方医科大学南方医院消化内科,510515 [2]深圳市龙华区人民医院消化内科,518109 [3]中山大学肿瘤防治中心内镜科,华南恶性肿瘤防治全国重点实验室,510060

出　　处：《现代消化及介入诊疗》2023年第3期287-290,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省医学科学技术研究基金项目(A2020462)。

摘　　要：目的研究胃镜检查时采用窄带成像(Narrow band imaging,NBI)模式是否能够比白光模式提高下咽及喉部病变的检出率。方法在我院拟行无痛胃镜检查患者中选取18岁及以上人群或既往有食管癌、鼻咽癌等病史人群,胃镜检查中均先后分别采用白光及NBI模式进行下咽及喉部的观察、记录。若进镜时无法完成上述部位观察,则待退镜时再进行相应观察、记录。最终,将白光模式与NBI模式的病变检出率进行对比。结果共入组1287例患者,其中男性761例,女性526例,共检出病变43例(检出率3.3%),其中肿瘤性病变28例(65.1%),恶性肿瘤20例(46.5%)。NBI模式检出全部43例病变,白光模式检出24例病变,统计学结果提示差异具有显著性。进一步对病变检出情况进行统计分析显示,男性及患有食管癌为下咽及喉部病变检出的危险因素。研究中未发生操作相关并发症。结论胃镜检查中采用NBI模式能够显著提高下咽及喉部病变检出率,此技术有望在食管癌高发区推广应用以促进下咽及喉部肿瘤的早诊早治。Objective To investigate whether using narrow band imaging(NBI)mode during gastroscopy can improve the detection rate of hypopharyngeal and laryngeal lesions compared with using white light imaging mode.Method Patients aged 18 and above or those with a history of esophageal cancer,nasopharyngeal cancer or other tumors were selected from the patients receiving gastroscopy under anesthesia at our hospital.White light imaging and NBI modes were used for observation and recording of hypopharynx and larynx during gastroscopy,respectively.If the observation could not be completed when entering the endoscope,it should be done when withdrawing the endoscope.Finally,the detection rate of hypopharyngeal and laryngeal lesions was compared between white light imaging mode and NBI mode.Results A total of 1287 patients were enrolled,including 761 males and 526 females.A total of 43 cases(detection rate of 3.3%)were detected,including 20 cases(46.5%)of malignant tumors among 28 cases(65.1%)of neoplastic lesions.Using NBI mode detected all 43 lesions,while using white light imaging mode detected 24 lesions.The statistical result showed significant difference.Further statistical analysis showed that males and those with esophageal cancer were risk factors for hypopharyngeal and laryngeal lesions.There were no procedure related complications in the study.Conclusions The use of NBI mode during gastroscopy can significantly improve the detection rate of hypopharyngeal and laryngeal lesions,and this technology is expected to be applied in high incidence areas of esophageal cancer to promote early diagnosis and treatment of hypopharyngeal and laryngeal tumors.

关 键 词：胃镜检查 窄带成像 下咽及喉 

分 类 号：R739.63[医药卫生—肿瘤] R573[医药卫生—临床医学]