Li J, Xu W, Cheng L Y
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Labortary of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 7;52(11):806-811. doi: 10.3760/cma.j.issn.1673-0860.2017.11.002.
To investigate the value of stroboscopy and narrow band imaging (NBI)endoscopy in the diagnosis of vocal cord leukoplakia. Two hundred and forty-six patients with vocal cord leukoplakia who underwent laryngeal microsurgery and diagnosed by histopathology were recruited between August 2014 and July 2016 in this retrospective study. The diagnostic accuracy of stroboscopy and narrow band imaging endoscopy in the diagnosis of vocal cord leukoplakia was compared. SPSS21.0 software was used to analyze the data. A significantly positive correlation was found between the decrease grade of mucosal wave and the histopathological diagnosis(=0.526, <0.01). A significantly positive correlation was found between the lesion classified by detailed morphologic findings of epithelial microvessel and the histopathological diagnosis(=0.480, <0.01). The sensitivity of stroboscopy for detecting severe dysplasia, carcinoma and invasive carcinoma was 92.73%, higher than NBI endoscopy. The specificity of NBI endoscopy was 90.55%, higher than stroboscopy. The results of logistic regression analysis showed: the positive pathological type risk in the group with mucosal waves severely reduced and absent was 3.906 and 19.737 times higher than the group with mucosal waves slightly reduced. In the group with mucosal waves severely reduced and absent, significant difference was observed when combined use of NBI endoscopy(<0.001, =0.047). In the diagnosis of vocal cord leukoplakia, stroboscopy is useful for detecting severe dysplasia, carcinoma and invasive carcinoma with high sensitivity. In the group with mucosal waves severely reduced and absent, combined use of NBI endoscopy was able to improve the diagnostic accuracy.
探讨频闪喉镜及窄带成像(NBI)内镜在声带白斑诊断中的价值。本回顾性研究纳入了2014年8月至2016年7月期间246例行喉显微手术并经组织病理学确诊为声带白斑的患者。比较频闪喉镜及窄带成像内镜诊断声带白斑的准确性。采用SPSS21.0软件进行数据分析。发现黏膜波降低程度与组织病理学诊断之间存在显著正相关(r = 0.526,P < 0.01)。上皮微血管详细形态学表现分类的病变与组织病理学诊断之间存在显著正相关(r = 0.480,P < 0.01)。频闪喉镜检测重度异型增生、癌及浸润癌的敏感度为92.73%,高于NBI内镜。NBI内镜的特异度为90.55%,高于频闪喉镜。Logistic回归分析结果显示:黏膜波严重降低及消失组的病理阳性类型风险分别是黏膜波轻度降低组的3.906倍和19.737倍。在黏膜波严重降低及消失组,联合应用NBI内镜差异有统计学意义(P < 0.001,P = 0.047)。在声带白斑的诊断中,频闪喉镜对检测重度异型增生、癌及浸润癌敏感度高,具有重要作用。在黏膜波严重降低及消失组,联合应用NBI内镜可提高诊断准确性。