窄带成像内镜在口咽癌和下咽癌及癌前病变诊断中的应用

吴俊华; 骆献阳

doi:10.13201/j.issn.1001-1781.2018.09.006

窄带成像内镜在口咽癌和下咽癌及癌前病变诊断中的应用

吴俊华,
骆献阳^,

- 厦门大学附属第一医院耳鼻咽喉头颈外科(福建厦门, 361000)

详细信息

通讯作者: 骆献阳, E-mail:lxy701@126.com

中图分类号: R739.6

收稿日期: 2018-01-04

Role of narrow band imaging in the detection of malignant lesions of the oropharynx and the laryngopharynx

WU Junhua,
LUO Xianyang^,

- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, Xiamen, 361000, China

More Information

Corresponding author: LUO Xianyang, E-mail: lxy701@126.com

Received Date: 04 January 2018

摘要

摘要: 目的:[HT5"SS]探讨窄带成像(NBI)内镜在口咽癌、下咽癌及癌前病变诊断中的应用价值。

关键词:
窄带成像 /

恶性肿瘤 /

内镜术 /

口咽 /

喉咽
Abstract: Objective: To explore the role of narrow band imaging (NBI) endoscopy in the diagnosis of oropharyngeal and laryngopharyngeal lesions.Method: NBI and white light (WLI) endoscopy were performed on 90 patients with oropharyngeal and laryngopharyngeal lesions from August 2016 to May 2017. NBI findings were classified into 5 types according to the Ni's classification and were compared with histopathological results. Accuracy of NBI on premalignant and malignant lesions were compared with WLI. The connection between NBI findings and phathological results were explored.Result: Sensitivity, specificity, PPV, and NPV of NBI vs WLI were 98.8% vs 83.7%, 89.2% vs 86.5%, 95.5% vs 93.5%, and 97.1% vs 69.6%, respectively. NBI findings were highly consistent with the phathological results (kappa=0.901, P<0.01). However, consistency between WLI findings and the phathological results was relatively low (kappa=0.657, P<0.01). NBI was more accurate in diagnosing both premalignant (P<0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, P<0.01) than WLI. NBI findings correlated with the phathological results (r=0.820, P<0.01).Conclusion: NBI shows high accuracy in detecting premalignant and malignant lesions of oropharynx and laryngopharynx; Ni's NBI classification helps to diagnose the premalignant and early malignant lesions and evaluate tumor invasion. Thus, NBI can contribute more in the diagnosis and minimally invasive treatment of premalignant and malignant lesions of oropharynx and laryngopharynx.
- narrow band imaging /
- carcinoma /
- endoscopy /
- oropharynx /
- hypopharynx

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参考文献(16)

[1]	单珊, 崔兰珍, 苗玉花, 等.二甲双胍抑制下咽癌裸鼠移植瘤生长的实验研究[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (21):1680-1684.
[2]	贾立峰, 李晓明, 申宇鹏, 等.双氢青蒿素对下咽癌Fadu细胞凋亡的影响[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (21):1685-1688.
[3]	倪晓光.电子喉镜临床应用:鼻咽喉部肿瘤窄带成像内镜图谱[M].北京:人民卫生出版社, 2015:30-33.
[4]	PASCARENCO O D, COROM F, PASCARENCO G, et al.A preliminary feasibility study:Narrow-band imaging targeted versus standard white light endoscopy non-targeted biopsies in a surveillance Barrett's population[J].Dig Liver Dis, 2016, 48:1048-1053.
[5]	YU H, YANG A M, LU X H, et al.Magnifying narrow-band imaging endoscopy is superior in diagnosis of early gastric cancer[J].World J Gastroenterol, 2015, 21:9156-9162.
[6]	GIULIANELLI R, GENTILE B C, ALBANESI L, et al.Narrow band imaging (NBI) cystoscopy and assisted bipolar TURBT:A preliminary experience in a single centre[J].Arch Ital Urol Androl, 2017, 89:232-235.
[7]	ZHU J, LI W, ZHOU J, et al.The diagnostic value of narrow-band imaging for early and invasive lung cancer:a meta-analysis[J].Clinics (Sao Paulo), 2017, 72:438-448.
[8]	SUN C, HAN X, LI X, et al.Diagnostic performance of narrow band imaging for laryngeal cancer:a systematic review and meta-analysis[J].Otolaryngol Head Neck Surg, 2017, 156:589-597.
[9]	倪晓光.电子喉镜临床应用:鼻咽喉部肿瘤窄带成像内镜图谱[M].北京:人民卫生出版社, 2015:457-457.
[10]	NI X G, HE S, XU Z G, et al.Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging[J].J Laryngol Otol, 2011, 125:288-296.
[11]	MUTO M, NAKANE M, KATADA C, et al.Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites[J].Cancer, 2004, 101:1375-1381.
[12]	VILASECA I, VALLS-MATEUS M, NOGUÉS A, et al.Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions[J].Head Neck, 2017, 39:1854-1863.
[13]	TIRELLI G, PIOVESANA M, BONINI P, et al.Follow-up of oral and oropharyngeal cancer using narrowband imaging and high-definition television with rigid endoscope to obtain an early diagnosis of second primary tumors:aprospective study[J].Eur Arch Oto- rhinolaryngol, 2017, 274:2529-2536.
[14]	MORIMOTO H, YANO T, YODA Y, et al.Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma[J].World J Gastroenterol, 2017, 23:1051-1058.
[15]	BACK L J J, REKOLA J, RAITTINEN L, et al.The feasibility of NBI in patients with suspected upper airway lesions:a multicenter study[J].Laryngoscope, 2017, 127:1821-1825.
[16]	INOUE H, KAGA M, IKEDA H, et al.Magnification endoscopy in esophageal squamous cell carcinoma:a review of the intrapapillary capillary loop classification[J].Ann Gastroenterol, 2015, 28:41-48.