窄带成像内镜技术在克服声带白斑遮蔽黏膜微血管形态中的应用

朱国臣; 肖大江; 孙屏

doi:10.13201/j.issn.1001-1781.2019.06.016

窄带成像内镜技术在克服声带白斑遮蔽黏膜微血管形态中的应用

- 1 南京医科大学附属无锡市第二人民医院耳鼻咽喉头颈外科(江苏无锡, 214002);
- 2 南京医科大学附属无锡市第二人民医院病理科
基金项目:
无锡市科技局科技发展基金项目 (No:CSE31N1706)

无锡市卫计委科研面上项目 (No:YGZXM1514)

详细信息

通讯作者: 朱国臣,E-mail:zgc2003doctor@sina.com

中图分类号: R767.4

收稿日期: 2019-01-06

Narrow-band imaging for overcoming the microvascular pattern hidden under the plaque of the vocal fold leukoplakia

- 1 Department of Otorhinolaryngology Head and Neck Surgery, Wuxi Second People's Hospital, Affiliated with Nanjing Medical University, Wuxi, 214002, China;
- 2 Department of Pathology, Wuxi Second People's Hospital, Affiliated with Nanjing Medical University

More Information

Corresponding author: ZHU Guochen, E-mail: zgc2003doctor@sina.com

Received Date: 06 January 2019

摘要

摘要: 目的:探讨窄带成像(NBI)内镜技术在克服声带白斑遮蔽黏膜微血管形态中的应用。方法:斑块遮蔽其下方微血管形态的声带白斑患者89例,根据斑块周围上皮内乳头样毛细血管袢(IPCL)形态对NBI内镜下斑块周围微血管表现分组,NBI内镜下良性组(20例)行黏膜下声带切除术,可疑恶性组(45例)行声韧带下声带切除术,恶性组(24例)行经声带肌的声带切除术。在此基础上行支撑喉镜下活检,并与组织病理学进行比较。结果:病理类型为单纯鳞状上皮细胞增生10例、轻度异型增生8例、中度异型增生21例、重度异型增生和原位癌41例、浸润癌9例。声带白斑NBI内镜下病变性质的恶性程度与病理分型的恶性程度行Spearman相关分析,呈显著正相关(r=0.725,P<0.01)。结论:NBI内镜可克服声带白斑的"雨伞效应",白斑周围黏膜的微血管形态与病理学结果具有很好的相关性,且NBI内镜有助于判断声带白斑的活检深度。
- 声带白斑 /
- 窄带成像 /
- 上皮内乳头样毛细血管袢
Abstract: Objective: To explore the application of narrow-band imaging (NBI) in overcoming the microvascular pattern hidden under the plaque of vocal fold leukoplakia.Method: According to the morphology of intraepithelial papillary capillary loops (IPCL) around the plaque of vocal cord leukoplakia under NBI endoscopy,89 patients with microvascular morphology covered by plaque were divided into different groups. Subepithelial cordectomy was performed in 20 cases of benign group, subligamental cordectomy was performed in 45 cases of suspected malignant group, and transmuscular cordectomy was performed in 24 cases of malignant group, respectively. The lesions of vocal fold were biopsied with suspension micro-laryngoscope, and pathological examinations were also observed. Result: Pathological diagnoses showed that there were 10 cases of squamous epithelial hyperplasia, 8 cases of mild dysplasia, 21 cases of moderate dysplasia, 41 cases of severe dysplasia and carcinoma in situ, and 9 cases of invasive cancer, respectively. Spearman's analysis showed that there was a stronge positive correlation between the microvascular pattern of peripheral regions surrounding the plaque by NBI endoscopy and malignant degree of pathological classification(r=0.725, P<0.01). Conclusion: NBI endoscopy can overcome the "umbrella effect" of vocal cord leukoplakia. The microvascular morphology of the mucosa around the leukoplakia has a good correlation with final pathological diagnoses, and NBI endoscopy is helpful to determine the biopsy depth of the vocal cord leukoplakia.
- vocal fold leukoplakia /
- narrow-band imaging /
- intraepithelial papillary capillary loop

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