窄带成像内镜在喉癌前病变诊断中的应用价值[论著]

目的　探讨窄带成像（narrow band imaging，NBI）内镜在诊断喉癌前病变中的应用价值。方法　选取2019年1月～2020年6月新疆医科大学第二附属医院耳鼻咽喉头颈外科以声音嘶哑及咽喉部不适为主诉就诊，由门诊专科技术人员分别在NBI和普通电子喉镜两种不同内镜模式下进行咽喉部检查后，再行喉部CT检查收治入院患者共90例，男55例，女35例，年龄（45.2±15.3）岁。所有患者根据检查结果预先评估肿瘤性质后，再以术后病理诊断为“金标准”进行对照分析。结果　90例患者中有23例确诊恶性肿瘤，67例为良性肿瘤（其中喉癌前病变38例）。在血管清晰度及图像清晰度两个方面，两种内镜模式检查结果组间差异均有统计学意义（χ2分别为3.989、4.012，P＜0.05）。在良性肿瘤、喉癌前病变及喉癌的诊断上，NBI内镜的准确率明显高于普通电子喉镜。而在良性肿瘤方面，差异无统计学意义，但在癌前病变及喉癌的诊断及总检出率中，差异均有统计学意义（P＜0.05）。结论　NBI内镜对喉癌前病变的检出率更高于普通电子喉镜，尤其在发现微小病灶方面更有优势，对及早发现早期病变、提高准确率有着重要的意义。

The value of NBI endoscopy in the diagnosis of precancerous lesions of the larynx

Objective To explore the application value of narrow band imaging(NBI)endoscopy in the diagnosis of laryngeal precancerous lesions.Methods Selected from January 2019 to June 2020,the Department of Otorhinolaryngology,Head and Neck Surgery,Second Affiliated Hospital of Xinjiang Medical University,was treated with hoarseness and throat discomfort as the main complaint,and the outpatient specialist technicians performed two different endoscopes,NBI and general electronic laryngoscope.After throat examination under the mode,a total of 90 patients were admitted to the hospital by CT examination of the larynx,55 males and 35 females,aged(45.2±15.3)years old.After all patients pre-assessed the nature of the tumor based on the examination results,the postoperative pathological diagnosis was used as the"gold standard"for comparative analysis.Results Among the 90 patients,23 were diagnosed as malignant tumors and 67 were benign tumors(including 38 precancerous lesions of the larynx).In terms of blood vessel clarity and image clarity,the results of the two endoscopic modes were statistically significant(x²=3.989,x²=4.012,P<0.05).In the diagnosis of benign tumors,precancerous lesions and laryngeal cancer,the accuracy of NBI endoscopy is significantly higher than that of ordinary electronic laryngoscopes.In terms of benign tumors,the difference was not statistically significant,but in the diagnosis and total detection rate of precancerous lesions and laryngeal cancer,the differences were statistically significant(P<0.05).Conclusions The detection rate of NBI endoscopy for laryngeal precancerous lesions is higher than that of ordinary electronic laryngoscopes,especially in the detection of small lesions,which is of great significance for early detection of early lesions and improvement of accuracy.