窄带成像内镜对咽喉部位肿瘤患者活检中的应用价值

Application of narrow-band imaging endoscopy in laryngeal malignant lesion biopsy

摘要:

目的??探讨窄带成像内镜（NBI）对咽喉部位肿瘤患者活检中的应用价值，为咽喉部位肿瘤的鉴别诊断提供参考。方法??共纳入100例怀疑咽喉部位恶性肿瘤的患者作为研究对象，均在普通白光及NBI内镜条件下进行活检，并以最终病理结果为金标准，评价两种检查方法的应用价值。结果??100例怀疑咽喉部位恶性肿瘤患者中，最终病理确诊恶性56例，占56.0%，良性病变44例，占44.0%。普通白光活检正确率60.0%明显低于NBI内镜活检正确率75.0%，比较差异有统计学意义（P <0.05）。NBI内镜敏感度为89.3%，特异度为63.6%均明显高于普通白光敏感度为75.0%，特异度为40.9%，比较差异有统计学意义（χ2=3.90，4.56，P =0.048，0.033）。结论??NBI内镜下咽喉部肿瘤为边界清晰的棕色斑点或条索状，活检中选取上述部位可提高恶性肿瘤的诊断敏感度、特异度及正确率。

Abstract:

Objective?To investigate the guiding role of narrow-band imaging endoscopy in laryngeal malignant lesion biopsy.?Methods?100 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 hrynx. 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 compared to the corresponding white light and NBI images.?Results?In 100 patients, 56 patients (56.0 %) were malignant tumors and 44 patients (44.0 %) were benign lesions. The diagnostic accuracy by NBI for the laryngeal lesions was 75.0 %, which was significantly higher than that of white light (60.0 %, P < 0.05). The sensitivity and specificity by NBI were 89.3 %, 63.6 %, which were significantly higher than that of white light (75.0 %, 40.9 %, P < 0.05).?Conclusion?Narrow-band imaging endoscopy can obviously improve in the detection of laryngeal malignant lesion by biopsy.