电子喉镜窄带成像模式在检出喉乳头状瘤病灶中的应用

doi:10.16150/j.1671-2870.2022.05.013

摘要/Abstract

摘要：

目的：观察电子喉镜窄带成像（narrow band imaging，NBI）模式在检出喉乳头状瘤病灶中的效能。方法：以2018年2月至2021年9月在上海交通大学医学院附属瑞金医院耳鼻咽喉科就诊并经支撑喉镜显微手术病理确诊的59例喉乳头状瘤患者为研究对象。以病理检查结果为对照，观察比较电子喉镜白光模式与NBI模式的对喉乳头状瘤检出率和漏诊情况。结果：59例患者，其中病灶单发者为34例，多发者为25例；支撑喉镜显微手术病理共确诊喉乳头状瘤病灶98个电子喉镜。NBI模式检出率高于白光组（84个比61个，85.71%比62.24%，P<0.01）。在单发组34个病灶中，NBI模式检出率大于白光组（30个比23个，88.24% 比67.65%，P<0.05）；在多发组64个病灶中，NBI模式检出率亦高于白光组（54个比38个，84.38%比 59.38%，P<0.01）。NBI模式下，漏诊直径≤3 mm的病灶12个，漏诊直径>3 mm的病灶2个；白光模式下，漏诊直径≤3 mm的病灶13个，漏诊直径>3 mm的病灶24个。2种模式间在>3 mm病灶漏诊间差异有统计学意义（P<0.01）。NBI模式漏诊部位主要位于会厌喉面（57.14%）和声带前联合（42.86%），白光模式漏诊部位主要位于会厌喉面（54.05%）和声带前联合（32.43%）。结论：在喉乳头状瘤病灶检查中，电子喉镜NBI模式相较于白光模式的检出率更高，且在检出多发喉乳头状瘤病灶中有着较大的应用价值。

关键词: 窄带成像, 喉乳头状瘤, 电子喉镜

Abstract:

Objective: To explore the efficacy of narrow band imaging (NBI) for diagnosing laryngeal papilloma (LP) detection. Methods: From February 2018 to September 2021, a total of 59 patients with pathologically confirmed LP were enrolled in this study. The detection rate and missed detection rate of LP by NBI were calculated and were compared with those by white light endoscopy. Results: There were 34 cases with single lesion (signal group) and 25 cases with multiple lesions (multiple group). The detection rate of LP by NBI was higher than that by white light pattern (84 vs 61, 85.71% vs 62.24%, P<0.01). The detection rate of LP by NBI was higher than that by white light pattern (30 vs 23, 88.24% vs 67.65%, P<0.05) in single group as well as in the multiple groups (54 vs 38, 84.38% vs 59.38%, P<0.01). By NBI pattern, the number of missed lesions with diameter ≤3 mm was 12, and the number of missed lesions with diameter>3 mm was 2. By white mode, the number of missed lesions with diameter ≤3 mm was 13, and the number of missed lesions with diameter>3 mm was 24. There was significant difference in missed lesions with diameter >3 mm between the two modes (P<0.01). The missed lesions by NBI were located in the laryngeal surface of epiglottis (57.14%) and the anterior vocal cord (42.86%), while by white light pattern were mainly located in the laryngeal surface of epiglottis (54.05%) and the anterior vocal cord (32.43%). Conclusions: The detection rate of LP by electronic laryngoscope NBI pattern is higher than that by white light pattern. It indicates that NBI has advantage in detecting multi LP lesions over white light pattern.

Key words: Narrow band imaging, Laryngeal papilloma, Electronic laryngoscope

中图分类号:

R739.65

陈旎珺, 施知泓, 吴继昌. 电子喉镜窄带成像模式在检出喉乳头状瘤病灶中的应用[J]. 诊断学理论与实践, 2022, 21(05): 625-628.

CHEN Nijun, CHI Zhihong, WU Jichang. Application of narrow-band imaging in the detection of laryngeal papilloma[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(05): 625-628.

图/表 3

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模式	会厌喉面	声带前联合	室带	披裂	声带
NBI	8（57.14%）	6（42.86%）	0（0）	0（0）	0（0）
白光	20（54.05%）	12（32.43%）	2（5.41%）	2（5.41%）	1（2.7%）