窄带成像技术指导声门型喉鳞状细胞癌内镜手术切缘范围的意义  

Clinical significance of narrow-band imaging in guiding safe surgical margin in glottic laryngeal squamous cell carcinoma

作　　者：孙贵虎 李大伟[1] 郭爽[1] 张冬梅[1] 崔世会 SUN Guihu;LI Dawei;GUO Shuang;ZHANG Dongmei;CUI Shihui(Department of Otolaryngology,Dalian Third People’s Hospital,Dalian 116000,Liaoning,China)

机构地区：[1]大连市第三人民医院耳鼻喉科,辽宁大连116000

出　　处：《中国现代医生》2023年第16期55-58,共4页China Modern Doctor

基　　金：大连市医学科学研究计划项目(1811051)。

摘　　要：目的探讨窄带成像技术(narrow-band imaging,NBI)指导声门型喉鳞状细胞癌内镜手术切缘范围的临床意义。方法选取2018年2月至2020年2月于大连市第三人民医院就诊的喉鳞状细胞癌患者66例,所有患者术前均分别应用NBI模式与白光模式评估黏膜病变范围及病变周围细微血管形态,并确定手术切除范围;术中分别应用两种不同模式指导切除肿瘤,比较两种模式对应的冰冻病理结果,记录肿瘤复发率及并发症。结果NBI模式的诊断符合率、敏感度、特异性、阳性预测值及切缘阴性率分别为96.9%、85.7%、97.5%、66.7%、94.5%;白光模式的诊断符合率、敏感度、特异性、阳性预测值及切缘阴性率分别为82.8%、61.5%、88.2%、57.1%、79.7%。所有患者均未出现术中或术后出血、血肿、涎腺瘘等严重并发症。1年内术后复发3例,复发率4.5%。结论NBI模式可更准确地判断声门型喉鳞状细胞癌的手术切除范围,降低因肿瘤不完全切除而导致的局部复发风险。Objective To investigate the clinical significance of narrow-band imaging(NBI)in guiding safe surgical margin in glottic laryngeal squamous cell carcinoma.Methods A total of 66 patients with laryngeal squamous cell carcinoma admitted to Dalian Third People’s Hospital from February 2018 to February 2020 were selected.All patients were evaluated by NBI mode and white light mode before surgery to determine the scope of mucosal lesions and peripheral vascular morphology,and to determine the scope of surgical resection.During the operation,two different modes were used to guide tumor resection.The corresponding frozen pathological results of the two modes were compared,and the recurrence rate and complications of the tumor were recorded.Results The diagnostic coincidence rate,sensitivity,specificity,positive predictive value and negative margin of NBI mode were 96.9%,85.7%,97.5%,66.7%and 94.5%,respectively.The diagnostic coincidence rate,sensitivity,specificity,positive predictive value and negative margin rate of white light mode were 82.8%,61.5%,88.2%,57.1%and 79.7%,respectively.No serious complications such as intraoperative or postoperative hemorrhage,hematoma,salivary gland fistula were found in all patients.Three cases recurred within one year,and the recurrence rate was 4.5%.Conclusion NBI model can more accurately determine the scope of surgical resection of glottic laryngeal squamous cell carcinoma and reduce the risk of local recurrence due to incomplete tumor resection.

关 键 词：声门型喉鳞状细胞癌 窄带成像技术 安全切缘 

分 类 号：R762[医药卫生—耳鼻咽喉科]