支撑喉镜CO_(2)激光术后复发的喉癌患者窄带成像特征分析  

Analysis of NBI characteristics in recurrent laryngeal cancer patients after CO_(2)laser surgery under suspend laryngoscopy

作　　者：刘小红[1] 郭瑞昕 谢萌 石瑶 曹楠 任晓勇[1] 罗花南[1] LIU Xiaohong;GUO Ruixin;XIE Meng;SHI Yao;CAO Nan;REN Xiaoyong;LUO Huanan(Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiao Tong University,Xi'an,Shaanxi,710004,China)

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科,陕西西安710004

出　　处：《中国耳鼻咽喉头颈外科》2024年第7期409-413,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析行支撑喉镜CO_(2)激光术后复发的早期声门型喉癌患者的窄带成像(NBI)内镜特征。方法回顾性分析2017年1月~2023年12月就诊于西安交通大学第二附属医院耳鼻咽喉头颈外科的Ⅰ~Ⅱ期声门型喉癌患者中,行支撑喉镜CO_(2)激光术后复发者。系统收集复发者术前、术后1个月、3个月、6个月等不同时间点的病史、治疗方式、喉镜检查、影像学检查和病理结果,总结复发者NBI内镜特征。结果18例行支撑喉镜CO_(2)激光术后复发的早期声门型喉癌患者,NBI内镜诊断喉癌复发的诊断率显著高于普通白光内镜(88.89%vs.55.56%,χ^(2)=4.985,P=0.026)。所有复发患者按ELS分型,上皮内乳头样毛细血管袢(intraepithelial papillary capillary loop,IPCL)均为垂直血管;按Ni分型,72.22%(13/18)IPCL为V型,27.78%(5/18)IPCL仅表现为可疑异常新生血管(点状或扩张弯曲)。术后随访时的NBI内镜特征显示:术后1个月、3个月、6个月,术区表面有异常IPCL的患者比例分别为0.00%、27.78%(5/18)、61.11%(11/18),差异有统计学意义(χ^(2)=16.164,P<0.001),即喉癌复发患者随访时间越长,NBI内镜下术区表面有异常IPCL的患者比例越高。结论对行支撑喉镜CO_(2)激光术后的早期声门型喉癌患者,当NBI内镜下出现V型IPCL或点状、扩张弯曲的可疑新生血管时,可能早期提示喉癌复发。OBJECTIVE To analyze the narrow-band imaging(NBI)endoscopic characteristics of recurrent early glottic carcinoma patients after undergoing CO_(2)laser surgery with a suspend laryngoscopy.METHODS A retrospective study was conducted on patients with early-stage glottic carcinoma(I-II stage)who received CO_(2)laser surgery under supportive laryngoscopy at the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiao Tong University from January 2017 to December 2023.The medical history,treatment methods,laryngoscopy(including common white light endoscopy and NBI endoscopy),imaging examinations,and pathological results of patients with recurrent glottic carcinoma were collected at different time points including preoperation,postoperative 1 month,postoperative 3 months,and postoperative 6 months.The endoscopic characteristics of NBI in patients with recurrent glottic carcinoma were summarized.RESULTS First,among 18 patients with early-stage glottic cancer recurrence after CO_(2)laser,the diagnostic rate of NBI endoscopy for laryngeal cancer recurrence(88.89%,16/18)was significantly higher than that of common white light endoscopy(55.56%,10/18)(χ^(2)=4.985,P=0.026).The intraepithelial papillary capillary loop(IPCL)was classified as a vertical vessel according to ELS in all relapsed patients.However,according to Ni classification,the IPCL of the 72.22%(13/18)were classified as type V,while the IPCL of 27.78%(5/18)showed suspicious abnormal neovascularization(punctate or dilated and curved).The proportion of patients with abnormal IPCL on the surgical surface at 1 month,3 months,and 6 months postoperatively was 0.00%,27.78%(5/18),and 61.11%(11/18),respectively,with statistically significant differences(χ^(2)=16.164,P<0.001),which indicated that the longer the follow-up time for recurrent laryngeal cancer patients,the higher the proportion of patients with abnormal IPCL on the surface of the surgical area under NBI endoscopy.CONCLUSION For early glottic carcinoma after CO_(2)laser

关 键 词：喉肿瘤 早期诊断 复发 窄带成像 

分 类 号：R739.65[医药卫生—肿瘤]