Pak Martin W, Chow Samuel, van Hasselt C A
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SAR China.
J Laryngol Otol. 2008 Feb;122(2):177-80. doi: 10.1017/S002221510600555X. Epub 2007 Jan 4.
A cross-sectional randomised single blind study was conducted to assess how concentrations of chromogen (vital stain) and the characteristics of the assessors affect the assessment of contact rhinoscopy. Twenty-eight patients who had undergone external radiotherapy for nasopharyngeal carcinoma were assessed by contact rhinoscopy using 0.5 per cent and 1 per cent methylene blue stain on opposite sides of the nasopharynx. Three independent observers assessed the visual clarity of the 45 contact endoscopic images showing squamous metaplasia according to a visual analogue scale. The intraclass correlation coefficients were 0.916 to 0.957 and 0.839 to 0.964 for intra-observer reliability of assessors in the groups of 0.5 per cent and 1 per cent stains, respectively. The intraclass correlation coefficients for inter-observer reliability of assessors were 0.884 and 0.885 in the groups of 0.5 per cent and 1 per cent stains, respectively. The mean scores of clarity of the cellular details were statistically higher in the group of 1 per cent stain among all assessors. These results showed that the assessment of squamous metaplasia by contact endoscopy is highly reliable irrespective of the clinical experience and knowledge of histopathology of the assessors. One per cent methylene blue should be the vital stain of choice in contact endoscopy.
进行了一项横断面随机单盲研究，以评估色原（活体染色剂）浓度和评估者特征如何影响接触式鼻内镜检查的评估。对28例接受过鼻咽癌体外放疗的患者进行接触式鼻内镜检查，在鼻咽部两侧分别使用0.5%和1%的亚甲蓝染色。三名独立观察者根据视觉模拟量表评估45张显示鳞状化生的接触式内镜图像的视觉清晰度。在0.5%染色组和1%染色组中，评估者的观察者内可靠性的组内相关系数分别为0.916至0.957和0.839至0.964。在0.5%染色组和1%染色组中，评估者的观察者间可靠性的组内相关系数分别为0.884和0.885。在所有评估者中，1%染色组的细胞细节清晰度平均得分在统计学上更高。这些结果表明，无论评估者的临床经验和组织病理学知识如何，通过接触式内镜检查评估鳞状化生都具有高度可靠性。1%的亚甲蓝应是接触式内镜检查中首选的活体染色剂。
