窄带成像内镜在喉癌诊断中的运用资料.pdfVIP

窄带成像内镜在喉癌诊断中的应用 倪晓光 贺舜 徐震纲 吕宁 高黎 袁峥 张月明 赖少清 易俊林 王晓雷 张蕾 李晓燕 王贵齐 【摘要】目的 探讨窄带成像（narrow band imaging，NBI）内镜在喉癌及其癌前病变诊断中的应用价 值。方法 自 2008 年 12 月至 2009 年 7 月对 122 例怀疑有喉癌或癌前病变的患者选用具有普通白光和NBI 两种观察模式的电子内镜进行咽喉部的检查。对发现的病灶依次使用白光和NBI模式进行分类和病灶性质的 判断，以病理诊断作为金标准，比较两种观察模式对喉癌的诊断作用。结果 122例患者中共发现了149个 病灶，其中息肉 16 个，炎性反应 7 个，单纯性增生 24 个，轻度不典型增生 17 个，中度不典型增生 6 个, 重度不典型增生6个，原位癌9个，浸润癌64个.NBI内镜对喉部病变的正确诊断率是90.6%（135/149）, 高于普通白光内镜的 75.2%（112/149）,两者比较差异有统计学意义（χ2=12.514，P0.001）。NBI内镜对 喉癌诊断的敏感性为93.2%（68/73），高于普通白光内镜的68.5%（50/73，χ2=14.317，P0.001）。结论 NBI 内镜通过识别黏膜表面微细血管形态变化提高对喉癌诊断的敏感性和喉部病变诊断的正确率，从而增强内 镜在喉癌术前诊断和术后随访中的作用。 【关键词】诊断显像；喉肿瘤；早期诊断；喉镜检查 Application of narrow band imaging endoscopy in the diagnosis of laryngeal cancer NI Xiao-guang*, HE Shun,XU Zhen-gang, Lu Ning, GAO Li, YUAN Zheng, ZHANG Yue-ming, LAI Shao 　 qing, YI Jun-lin, WANG Xiao-lei, ZHANG Lei, LI Xiao-yan, WANG Gui-qi. *Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences,Beijing 100021, China Corresponding author: WANG Gui-qi, Email:wangguiq@126.com 【Abstract 】Objective To investigate the value of narrow band imaging (NBI) endoscopy in the detection of laryngeal cancer and its precursor lesions. Methods Between December 2008 and July 2009, a total of 122 consecutive patients with suspected precancerous or cancerous lesions of the larynx were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of larynx.Full pharyngeal and laryngeal examination was performed first under white light endoscope and then under NBI. Each lesion was observed by NBI endoscopy and classified according to the detailed morphologic findings of epithelial microvessels.Histological results were then compar