接触性内窥镜在喉病变诊断中的应用

Application of contact endoscopy in diagnosing laryngeal lesions

目的 :研究接触性内窥镜在喉病变 ,特别是喉癌时做微创的病理学图像检查方法。方法 :在显微支撑喉镜下 ,在 84例喉内病变黏膜处涂 1%的美蓝染色 ,用 6 0×和 15 0×放大倍数的接触式内窥镜 (Karl -Storz 8715AA ,0° ,8715AB ,30° ,直径均为 5 .5mm ,长度 2 3mm)放置于黏膜表面 ,观察其病理变化 ,并与活检结果比较。结果 :接触性内窥镜的电子图像可较清晰的显示表面黏膜不同病变细胞及核的大小、形状、排列、与胞浆的比例、致密度和着色情况 ,有无中空细胞、核角蛋白 ,黏膜下微血管的排列情况。病理改变为 :任克式水肿 (n =8) ,慢性喉炎 (n =15 ) ,喉乳头状瘤 (n =8) ,黏膜白斑 (n =9) ,声带上皮分化不良 (n =18) ,恶性肿瘤 (n =32 ) ,其他 6例。结论 :接触性内窥镜作为一种新的微创的辅助检查方法 。

Objective:To study imaging technique of contact endoscopy for diagnosing laryngeal lesions, especially laryngeal cancer and its early lesions.Method:A standard microlaryngoscopy setup and general anesthesia were used in all 84 cases. The area of interest stained with 1% methylen blue using a syringe and the Storz contact endoscopy was guided down through laryngoscope towards the larynx until touching the exact area of interest. The pictures of contact endoscopy were viewed and biopsies of the same sites were then performed for histological comparing.Results:The imaging of contact endoscopy for laryngeal lesions showed clearly the pathological characteristics included cell and nuclear regularity, cell to cytoplasm ratio, regularity of vasculture and presence or absence of koilocytes and keratin. The pathological findings included Reinke's edema ( n =8), chronic laryngitis ( n =15), papilloma ( n =8), keratosis ( n =9), dysplasia ( n =18), carcinoma ( n =32) and others ( n =6).Conclusion:As a new kind of less invasive method, contact endoscopy is helpful to diagnosis and monitor laryngeal lesions, especially laryngeal cancer and its early lesions.