电子喉镜窄带成像技术模式在早期喉癌诊断中的应用及其与病理结果一致性的研究

Study on the application of electronic laryngoscope narrow-band imaging mode in diagnosis of early laryngeal cancer and its consistency with pathological results

摘要:

目的 探讨电子喉镜窄带成像技术（NBI）模式在早期喉癌诊断中的应用及与病理结果的一致性。方法 选取该院喉部病变患者80例，均行电子喉镜白光、NBI检查和病理检查，比较电子喉镜NBI模式与白光模式检查结果及图像质量，分析电子喉镜NBI模式与病理结果的一致性。结果 80例喉部病变患者均为单发病灶。病理性质为阳性（恶性）的29例中，鳞状细胞癌22例（Ⅴ型），原位癌7例（Ⅴ型）；阴性（非恶性）的51例中，5例中度不典型增生（Ⅳ型），18例单纯增生（Ⅲ型），18例慢性喉炎（Ⅱ型），10例声带息肉（Ⅰ型）。80例喉部病变患者电子喉镜NBI模式下阳性30例，阴性50例；白光模式下阳性23例，阴性57例；电子喉镜NBI模式检查敏感度、阴性预测值及准确度均高于白光模式，差异有统计学意义（P < 0.05）；电子喉镜NBI模式检查图像中，病变轮廓及微血管形态评分均高于白光模式，差异有统计学意义（P < 0.05）；电子喉镜NBI模式与病理结果符合率为80.00%（Kappa = 0.733，P = 0.000）。结论 电子喉镜NBI模式下黏膜表层微血管形态和结构清晰可见，更易识别早期病变，判断病变范围，且诊断结果与病理结果一致性较高，在早期喉癌诊断中具有良好的应用前景。

Abstract:

Objective To explore the application of electronic laryngoscope narrow-band imaging (NBI) mode in diagnosis of early laryngeal cancer and its consistency with pathological results.Methods 80 patients with laryngeal lesions were selected and underwent electronic laryngoscope white light, NBI pattern examination and pathological examination. The NBI and white light pattern examination results and image quality were compared, and the consistency between the electronic laryngoscope NBI pattern and the pathological results were analyzed.Results 80 patients with laryngeal lesions were all single lesions, of which 29 were pathologically positive (malignant), including 22 cases of squamous cell carcinoma (type V), 7 cases of carcinoma in situ (type V); Negative (non-malignant) 51 cases, including 5 cases of moderate dysplasia (type Ⅳ), 18 cases of simple hyperplasia (type Ⅲ), 18 cases of chronic laryngitis (type Ⅱ), 10 cases of vocal cord polyps (type Ⅰ). In 80 cases of laryngeal lesions, there were 30 positive cases and 50 negative cases under the electronic laryngoscope NBI mode; 23 cases positive and 57 negative cases under the white light mode; the sensitivity, negative predictive value and accuracy of the electronic laryngoscope NBI mode were higher than those under the white light mode, and the difference were statistically significant (P < 0.05); The lesion contour and microvessel morphology scores in the image of the electronic laryngoscope NBI mode were higher than those in the white light mode, and the differences were statistically significant (P < 0.05); The coincidence rate of the NBI mode of the electronic laryngoscope and the pathological results was 80.00% (Kappa = 0.733, P = 0.000).Conclusion Under the NBI mode of the electronic laryngoscope, the morphology and structure of the microvessels in the mucosal surface are clearly visible, and it is easier to identify the early lesions and determine the scope of the lesions, and the diagnostic results are highly consistent with the pathological results.