窄带成像技术观察鼻咽癌黏膜表面血管形态临床意义的探讨*

Clinical significance of mucosal microvascular morphological changes in nasopharyngeal carcinoma (NPC) under narrow band imaging (NBI)*

摘要:

目的   探讨窄带成像技术（NBI）辅助观察鼻咽癌黏膜表面血管形态的临床意义。方法   选取2015年1月-2015年6月至该院内窥镜室同时行白光及NBI模式下电子鼻咽镜检查患者共89例，分析其中病理确诊鼻咽癌患者NBI模式下鼻咽部黏膜表面血管形态特点，并参照患者肿瘤TNM分期，探讨鼻咽癌黏膜表面血管形态改变的临床意义。结果   89例患者中病理确诊鼻咽癌54例，NBI模式下将其黏膜表面血管形态依异型程度由轻到重可分为3型，其中Ⅰ型血管7例，Ⅱ型血管22例，Ⅲ型血管25例。在诊断鼻咽癌的54例患者中，Ⅰ、Ⅱ、Ⅲ型在T1～2组中分别为6、10、7例，在T3～4组中为1、12、18例，其中Ⅰ型血管多见于T1～2组，而Ⅲ型血管多见于T3～4组（P <0.05），Ⅱ型血管在T1～2组和T3～4组之间差异无统计学意义（P >0.05）。不同血管类型在不同肿瘤N分期、M分期及临床分期中的分布差异无统计学意义（P >0.05）。结论   NBI下鼻咽癌黏膜表面血管形态改变的程度可能与肿瘤局部侵袭程度有关。

Abstract:

Objective To study the clinical significance of mucosal microvascular morphological changes in nasopharyngeal carcinoma (NPC) under narrow band imaging (NBI). Methods From 2015. 01 to 2015. 06, 89 cases were examined with electronic nasopharyngolaryngoscope equipped with white light mode and NBI mode. The clinical significance of the morphological characteristics of mucosal superficial micro-vessels were evaluated combining with their tumor stage. Results 54 cases of these patients were confirmed NPC pathologically. Under NBI, the changes of mucosal microvascular morphological in NPC should be divided into three types. Among the 54 NPC patients, the cases of Ⅰ,Ⅱ,Ⅲ were respectively 6, 10, 7 in T1~2 group and 1, 12, 18 in T3~4 group. In addition, Ⅰ were seen more frequently in T1~2 group, while Ⅲ were seen more frequently in T3~4 group, the difference had statistically significance (P < 0.05). However, the difference of Ⅱ had not statistically significance between T1~2 group and T3~4 group (P > 0.05). There was no significance difference in N stage, M stage and NPC clinical stage among these three type of vessels (P > 0.05). Conclusion Under NBI, the changes of mucosal microvascular morphology maybe can indicate the tumor invasive depth.