窄带成像内镜在鼻咽癌诊断中的价值

Role of narrow-band imaging endoscopy in the diagnosis of nasopharyngeal carcinoma

目的探讨窄带成像(narrow band imaging,NBI)内镜在鼻咽癌诊断中的价值。方法自2009年1月～2010年3月对怀疑有鼻咽部占位的240例患者使用具有NBI观察模式的电子内镜进行鼻咽部的检查。观察NBI模式下鼻咽部不同性质病变的黏膜表面微血管形态学特点。结果鼻咽癌在NBI模式下可见病变表面出现细树枝状或扭曲线条状的新生血管,血管线条清晰明显,呈棕褐色。NBI内镜对鼻咽癌诊断的敏感性、特异性、阳性预测值和阴性预测值分别为80.6%、91_7%、96.7%和61.1%。结论 NBI内镜通过识别黏膜表面微细血管的形态变化提高内镜在鼻咽癌早期诊断中的作用。

OBJECTIVE To investigate the value of narrow band imaging（NBI） endoscopy in the diagnosis of nasopharyngeal carcinoma.METHODS Between January 2009 and March 2010,a total of 240 consecutive patients with suspected nasopharyngeal tumor were enrolled in this study.High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of nasopharynx. Each lesion was observed by NBI endoscopy and judged according to the detailed morphologic findings of epithelial microvessels.RESULTS The characteristics of nasopharyngeal carcinoma under NBI mode were that the superficial microvessel morphology appeared thin branch-like shape or torturous line shape on the surface of the lesions.The vascular line was clear and presented with brownish color.The sensitivity,specificity,positive predictive value,and negative predictive value of NBI in nasopharyngeal carcinoma were 80.6%,91.7%,96.7% and 61.1%,respectively.CONCLUSION NBI endoscopy is a promising tool for improving the early diagnosis of nasopharyngeal carcinoma in vivo by detection of the morphology of mucosal capillary vessels.