窄带成像内镜在喉部恶性病变活检中的应用

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

目的 探讨窄带成像（narrow band imaging,NBI）内镜在喉部恶性病变活检过程中的作用.方法 选取自2013年2月至2014年1月在天津市人民医院耳鼻咽喉头颈外科行电子鼻咽喉镜筛查,怀疑喉部恶性病变并取活检的患者113例,按照单、双日的随机方法将患者分为两组,白光组58例,在白光模式下行喉部肿物活检并送病理检查;NBI组55例,在NBI模式下行喉部肿物活检并送病理检查,两组患者均根据活检病理结果行相应的外科手术,并将手术切除组织送病理检查,将其病理学结果作为金标准.分别计算两组恶性病变活检检出率及活检正确检出率,并作统计学比较.结果 白光组恶性病变活检检出率为71.1％ （32/45）,低于NBI组的95.4％（42/44）,两者差异有统计学意义（x2=7.75,P＜0.05）;白光组活检正确检出率为77.6％（45/58）,低于NBI组的96.4％（53/55）,两者差异有统计学意义（x2=7.09,P＜0.05）.结论 窄带成像内镜能明显提高喉部恶性病变的活检检出率及正确检出率,可以起到定向指导活检的作用,减少喉部恶性病变的误诊及漏诊,具有很高的临床实用价值.

Objective To investigate the guiding role of narrow-band imaging endoscopy in laryngeal malignant lesion biopsy.Methods From February 2013 to January 2014,113 patients suspected of laryngeal malignant lesions after electronic nasopharyngolaryngoscope screening were included in the study.The patients were randomly divided into two groups,58 cases in group A underwent laryngeal tumor biopsies in the white light mode and 55 cases in group B did in NBI mode.The patients were applied with corresponding surgery treatment according to the biopsy results.Postoperative pathologic examination result was as a gold standard for identifing the laryngeal diseases.Results The positive rate of malignant lesions in group A （71.1％,32/45）was significantly lower than that in group B （95.4％,42/44） （x2 =7.75,P ＜ 0.05） ;the accurate rate of biopsy in group A （77.6％,45/58） was significantly lower than that in group B （96.4％,53/55,x2 =7.09,P ＜ 0.05）.Conclusion Narrow-band imaging endoscopy can obviously improve in the detection of laryngeal malignant lesion by biopsy.