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[窄带成像技术用于克服隐藏在声带白斑斑块下的微血管形态]

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

作者信息

Zhu G C, Xiao D J, Sun P

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Wuxi Second People's Hospital, Affiliated with Nanjing Medical University, Wuxi, 214002, China.

Department of Pathology, Wuxi Second People's Hospital, Affiliated with Nanjing Medical University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Jun;33(6):542-545. doi: 10.13201/j.issn.1001-1781.2019.06.016.

Abstract

To explore the application of narrowband imaging (NBI) in overcoming the microvascular pattern hidden under the plaque of vocal fold leukoplakia. 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. 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(=0.725, <0.01). 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.

摘要

探讨窄带成像(NBI)在克服声带白斑斑块下隐藏的微血管形态方面的应用。根据NBI内镜下声带白斑斑块周围上皮内乳头毛细血管袢(IPCL)的形态,将89例微血管形态被斑块覆盖的患者分为不同组。良性组20例行黏膜下声带切除术,疑似恶性组45例行韧带下声带切除术,恶性组24例行肌层声带切除术。用悬吊式显微喉镜对声带病变进行活检,并观察病理检查情况。病理诊断显示,分别有10例鳞状上皮增生、8例轻度不典型增生、21例中度不典型增生、41例重度不典型增生及原位癌、9例浸润癌。Spearman分析显示,NBI内镜下斑块周围周边区域的微血管形态与病理分类恶性程度呈强正相关(=0.725,<0.01)。NBI内镜可克服声带白斑的“伞效应”。白斑周围黏膜的微血管形态与最终病理诊断有良好的相关性,NBI内镜有助于确定声带白斑的活检深度。

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