内镜窄带成像技术指导靶向活检在喉癌诊断中的价值

The value of target biopsy using narrow band imaging endoscopy for diagnosis of laryngeal carcinoma

目的:探讨窄带成像技术(narrow band imaging,NBI)在喉癌靶向活检中的应用。方法:选取2012年8月至2014年12月在天津市人民医院耳鼻咽喉头颈外科就诊的可疑喉部恶性病变患者156例,分别行白光内镜和NBI内镜检查,记录图片资料并行病理活检,以病理组织学结果为金标准,比较白光内镜和NBI内镜在诊断喉癌上的差异。应用SPSS 16.0软件包进行统计学分析,使用χ2检验比较两组之间的差异。结果:NBI内镜能清晰显示病变范围指导靶向活检,对0期(Tis)、Ⅰ期、Ⅱ期喉癌的诊断正确率NBI内镜明显高于普通白光内镜,二者在诊断早期喉癌上的差异有统计学意义(χ2=22.00,P<0.05;χ2=8.33,P<0.05;χ2=4.55,P<0.05)。结论:在喉癌的诊断上NBI内镜能够区分黏膜病变组织和正常组织,并显示病变范围,显著优于普通白光内镜,具有很高的临床实用价值,有望成为喉部疾病筛查的常规手段,提高喉癌的早期确诊率及治疗效果。

Objective：To estimate the clinical significance of target biopsy in clinical diagnosis,and accurate pathologic specimen acquisition of laryngeal lesion by using narrow band imaging（NBI）endoscopy.Method：A total of 156 cases of patients with laryngeal lesions were collected from the department of Otolaryngology Head and Neck Surgery of Tianjin Union Medical Center from Aug 2012 to Dec 2014.All patients were randomly divided into regular biopsy group and NBI target biopsy group.Image data were recorded and the patients＇ samples were biopsied.The pathologic diagnosis was used to evaluate the accuracy of regular biopsy and target biopsy.Result：Based on the pathologic diagnosis,the correct accurate pathologic specimen acquisition rates in NBI target pathology group at stage 0（Tis）,stageⅠand stageⅡlaryngeal cancer diagnosis compliance rate were higher than those in regular biopsy group,stage 0（Tis）（χ^2=22.00,P〈0.05）,stageⅠ（χ^2=8.33,P〈0.05）and stageⅡ（χ^2=4.55,P〈0.05）.Conclusion：NBI endoscopy plays an important role in the clinical diagnosis and accurate pathologic specimen acquisition of laryngeal carcinoma and can be a regular means to detect laryngeal lesions in clinical.