窄带成像技术在咽喉部肿瘤早期诊断中的应用

发布时间：2018-08-11 11:20

【摘要】：目的:探讨窄带成像技术(NBI)在咽喉部肿瘤早期诊断中的应用价值。方法:使用NBI内镜对106例怀疑咽喉部良性或恶性病变患者进行检查,对白光和NBI内镜下发现的病变分别评估白光和NBI模式下病变表面毛细血管形态和病变边界的清晰度。然后分别对两种模式下可疑部位进行活检,标本保存在10%甲醛中送病理检查,并记录两种模式下病变的特征、部位及镜下诊断。所有患者根据活检病理组织学结果行相应的喉肿物切除术,以手术切除组织的病理组织学结果为诊断的金标准。分别计算两组恶性病变活检检出率及活检正确检出率,并进行统计学比较。结果:白光模式镜下诊断正确率75.47%,NBI模式镜下诊断正确率96.23%,两者差异有统计学意义(χ2=18.375,P0.01);白光模式下活检正确检出率82.08%,NBI模式下活检正确检出率95.28%,两者差异有统计学意义(χ~2=12.071,P0.01);白光模式内镜下恶性肿瘤正确检出率48.15%,NBI模式内镜下恶性肿瘤正确检出率92.59%,两者差异有统计学意义(χ~2=10.083,P0.01)。结论:NBI内镜下观察咽喉黏膜表面毛细血管的形态变化,能够提高早期咽喉癌的检出率,值得推广。
[Abstract]:Objective: to evaluate the value of narrow-band imaging (NBI) in the early diagnosis of pharyngeal and laryngeal tumors. Methods: NBI endoscopy was used to examine 106 patients with suspected benign or malignant laryngopharynx lesions. The white light and NBI endoscopy were used to evaluate the morphology of the surface capillaries and the definition of lesion boundary in white light and NBI mode respectively. The specimens were collected in 10% formaldehyde for pathological examination, and the pathological features, location and diagnosis under the two models were recorded. All the patients underwent laryngectomy according to the histopathological results of biopsy, and the gold criteria for diagnosis were the histopathological results of the resected tissues. The detection rate of biopsy and the correct rate of biopsy were calculated and compared statistically between the two groups. Results: the correct rate of diagnosis under white light mode was 75.47 and the accuracy rate of NBI mode was 96.23, the difference was statistically significant (蠂 2 / 18.375, P 0.01), and the correct rate of biopsy was 82.08% in NBI mode and 95.28% in NBI mode, the difference was statistically significant. The correct detection rate of malignant tumor in white light mode was 48.15% and 92.59% in NBI mode, and the difference was statistically significant (蠂 ~ (2 / 2) 10.083 / P ~ (0.01). Conclusion the morphological changes of capillary on the surface of pharynx and larynx mucosa can increase the detection rate of laryngeal carcinoma in early stage, which is worth popularizing.
【作者单位】：深圳市龙岗区第二人民医院眼耳鼻喉科;深圳市龙岗区第二人民医院德兴社康中心;深圳市龙岗区第二人民医院内镜诊疗科;深圳市龙岗区第二人民医院病理科;
【基金】：深圳市龙岗区科技创新局2014年度科技计划(扶持类)医疗卫生项目(No:201406103001030)
【分类号】：R739.6

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