电子喉镜联合窄带成像技术对喉部早期恶性病变的诊断价值

The Value of Narrow Band Imaging in the Diagnosis of Early Cancerous and Precancerous Lesions of Laryngeal and Hypopharynx

蒋锐;於子卫;陈立晓;

1:南京医科大学

2:江苏省昆山市中医医院耳鼻咽喉科

3:南京医科大学附属上海一院临床医学学院

4:上海市第一人民医院耳鼻咽喉头颈外科

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摘要

目的探讨电子喉镜联合窄带成像技术(narrow band imaging,NBI)诊断喉部早期恶性肿瘤及癌前病变的应用价值。方法选取2016年12月至2017年5月以喉部不适为主诉的患者共50例,男41例,女9例,平均年龄59.3±13.2岁,分别用白光及NBI电子喉镜进行喉部检查,并对每一例患者进行颈部增强CT检查,分别根据白光、NBI内镜和增强CT预估病灶的良恶性,以手术或活检病理结果作为诊断金标准进行对照分析。结果50例患者共发现病灶56个,其中,病理检查为良性病变36个,恶性肿瘤20个;白光和NBI内镜的敏感性分别为60.0%和90.0%(χ2=4.80,P=0.03),NBI内镜和增强CT检查的准确率分别为92.9%和75.0%(χ2=4.80,P=0.03),NBI内镜和增强CT检查的准确率分别为92.9%和75.0%(χ2=6.62,P=0.01),敏感性分别为90.0%和60.0%(χ2=6.62,P=0.01),敏感性分别为90.0%和60.0%(χ2=4.80,P=0.03),差异有统计学意义(均为P<0.05)。结论 NBI内镜能更好的观察到黏膜表面细微结构的变化,对于早期喉癌,其发现病变的能力及诊断的准确性均高于普通白光喉镜和增强CT检查,有利于早期诊断、确定活检部位和手术边界。

关键词

喉癌;癌前病变;电子喉镜;窄带成像技术

基金项目(Foundation):

作者

蒋锐;於子卫;陈立晓;

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