窄带光谱成像技术联合放大内镜在咽喉部肿瘤诊断中的应用

Value of magnifying endoscopy with narrow band imaging in diagnosis of laryngopharyngeal carcinoma

目的探讨窄带光谱成像技术(narrow band imaging,NBI)联合放大内镜检查在咽喉部肿瘤诊断中的应用价值。方法选取2011年7月至2014年6月我科胃镜中心的105 000例患者进行胃镜检查,在胃镜检查前先常规用白光进行咽喉部的观察,然后再用NBI模式光对咽部进行观察,发现病变及时送病理检查。结果检出咽喉部肿瘤22例(0.021%),包括进展期鳞状细胞癌10例(0.010%)和早期癌(包括高级别上皮内瘤变及原位癌)12例(0.011%)。其中在进展期鳞状细胞癌的诊断中,NBI内镜(9例)和白光内镜(10例),两组无显著差异(P>0.05);在早期癌的诊断中,NBI内镜(12例)和白光内镜(1例),两组有显著差异(P<0.01)。咽部癌并食道癌者共占45.45%(10/22),咽部癌合并直肠癌1例。结论 NBI放大内镜检查前对咽喉部早期癌的检出率优于白光内镜,但是对于进展期咽喉癌的诊断,NBI内镜和白光内镜无差异。在检查中应特别注意咽部癌和食道癌同时存在的情况。

Objective To investigate the value of magnifying endoscopy with narrow band imaging（NBI） in the diagnosis of laryngopharyngeal carcinoma.Methods A total of 105 000 patients were inspected by magnifying endoscopy in Xinqiao Hospital from July 2011 to June 2014.The pharynx and larynx were observed in both white light and NBI modes during gastroscopy.All lesions were identified pathologically.Results The detection rate of laryngopharyngeal tumor was 0.021%（22 /105 000）,including advanced squamous cell carcinoma（0.010%,10 cases） and early carcinoma（high grade intraepithelial neoplasia and carcinoma in situ）（0.011%,12 cases）.In the diagnosis of advanced stage squamous cell carcinoma,9 cases and 10 cases were detected by NBI endoscopy and white light endoscopy,respectively,and there was no statistically significant difference in the detection rate（P 〉 0.05）.In the diagnosis of early carcinoma,12 cases and 1 case were found by NBI endoscopy and white light endoscopy,respectively,and the detection rate had statistical significance（P 〈 0.01）.Laryngopharyngeal carcinoma accompanied by esophageal carcinoma accounted for 45.45%（10 /22）,and one case of laryngopharyngeal carcinoma accompanied by rectal carcinoma was found.Conclusion The detection rate of early laryngopharyngeal carcinoma by magnifying endoscopy with NBI is higher than that by white light endoscopy,but for the detection rate of advanced laryngopharyngeal carcinoma,NBI endoscopy and white light endoscopy have no difference.Special attention should be paid to the patients with laryngopharyngeal carcinoma accompanied by esophageal carcinoma.