智能分光比色技术在喉部肿瘤早期诊断中的应用

发布时间：2018-05-02 20:39

  本文选题：FICE + 喉癌前病变　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨喉部肿瘤智能分光比色技术(flexible spectral imaging color enhancement,FICE)特点及FICE内镜在喉部肿瘤早期诊断中的应用价值方法:收集自2015年3月至2016年12月63例疑似喉部肿瘤的患者,使用EG-590ZW电子胃镜,它具有白光内镜(white light endoscopy,WLE)和FICE内镜两种观察模式,分别对喉部病变进行观察、摄图并保存。通过对黏膜及黏膜下毛细血管形态及走形、病灶边界,比较两种观察模式下图像清晰度;比较两种内镜模式下正确诊断率;对比两种模式下的喉癌前病变、喉癌的敏感性及特异性;FICE内镜模式下对喉部病变血管分型。结果:1、FICE内镜在血管形态、走形及病灶边界的显示上都明显优于普通白光内镜((49)0.05)。2、在63例喉部肿物中共发现85个病灶,其中良性病变28个(包括慢性炎性、息肉、单纯性增生),轻度不典型增生9个,中度不典型增生3个,重度不典型增生3个,原位癌6个,浸润癌36个。FICE内镜对喉癌病变的正确诊断率是91%,高于普通白光内镜的68.2%,两者比较差异有统计学意义((49)0.05);FICE内镜对喉癌前病变及喉癌的敏感性92.4%,高于普通白光内镜的74.6%,具有统计学意义((49)0.05);FICE内镜对于喉癌前病变及喉癌的特异性91.8%,普通白光内镜的87.8%((49)0.05),无统计学意义。3、FICE分级与病理诊断关系:Ⅰ型患者:息肉8例,Ⅱ型患者:慢性炎症18例,息肉2例,其诊断对良性病变的敏感性为92.8%;Ⅲ型患者:轻度不典型增生8例,中度不典型增生3例,其诊断不典型增生的敏感性为100%,Ⅳ型患者:轻度不典型增生1例,中度不典型增生2例,重度不典型增生及原位癌6例,浸润癌1例,差异有统计学意义((49)0.05);V型患者:浸润癌占100%,其诊断浸润癌的敏感性为97.2%(35/36)。结论:1、与普通白光模式相比,FICE模式对于病变的轮廓、黏膜层及黏膜下层微血管的形态及走形变化可清晰地显现出来,增强病变识别度。2、FICE内镜对喉癌前病变和喉癌病变诊断的正确率、敏感性,比普通白光模式具有明显优势,从而增强内镜在喉癌前病变和喉癌术前诊断和术后随访中的作用。3、通过FICE模式下对血管形态分型,可更早发现喉部肿瘤早期病变及微小病灶。
[Abstract]:Objective: to investigate the characteristics of flexible spectral imaging color enhancement technique and the value of FICE endoscopy in the early diagnosis of laryngeal neoplasms. From March 2015 to December 2016, 63 suspected laryngeal neoplasms were collected. Using EG-590ZW electronic gastroscope, it has two observation modes: White light endoscopy WLEand FICE endoscopy. The laryngeal lesions are observed, photographed and preserved respectively. By comparing the morphology and shape of the mucosal and submucosal capillary, the boundary of the lesion, the clarity of the image in the two observation modes, the correct diagnostic rate under the two kinds of endoscopic modes, and comparing the laryngeal precancerous lesions in the two modes, Sensitivity and specificity of laryngeal carcinoma in vascular classification of laryngeal lesions under nice endoscopy. Results the vascular morphology, anatomic shape and lesion boundary were obviously superior to those of common white light endoscopy in displaying vascular morphology, morphology and lesion boundary. 85 lesions were found in 63 laryngeal masses, of which 28 were benign lesions (including chronic inflammatory polyps, polyps). There were 9 mild atypical hyperplasia, 3 moderate atypical hyperplasia, 3 severe atypical hyperplasia and 6 carcinoma in situ. The correct diagnostic rate of invasive carcinoma 36. Nice endoscopy for laryngeal cancer lesions was 91, which was higher than that of ordinary white light endoscopy. The difference between them was statistically significant. The sensitivity of nice endoscopy to laryngeal precancerous lesion and laryngeal carcinoma was 92.4%, higher than that of ordinary white light endoscopy 74.6%. The specificity of nice endoscopy for laryngeal precancerous lesion and laryngeal carcinoma was 91.8%, while that of common white light endoscopy was 49.08%. There was no statistical significance. 3FICE grade had no relationship with pathological diagnosis: type 鈪，

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