使用窄带成像与常规白光成像评估喉咽肿瘤的扩展。
Evaluating Laryngopharyngeal Tumor Extension Using Narrow Band Imaging Versus Conventional White Light Imaging.
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Otorhinolaryngology, Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands.
出版信息
Laryngoscope. 2021 Jul;131(7):E2222-E2231. doi: 10.1002/lary.29361. Epub 2021 Jan 4.
OBJECTIVE/HYPOTHESIS: Comparing detection and extension of malignant tumors by flexible laryngoscopy in the outpatient setting with laryngoscopy under general anesthesia using both White Light Imaging (WLI) and Narrow Band Imaging (NBI).
STUDY DESIGN
Prospective study.
METHODS
Two hundred and thirty-three patients with laryngeal and pharyngeal lesions underwent flexible and rigid laryngoscopy, with both WLI and NBI. Extension of malignant lesions (n = 132) was compared between both techniques in detail.
RESULTS
Sensitivity of NBI during flexible endoscopy (92%), was comparable with that of WLI during rigid endoscopy (91%). The correlation of tumor extension between flexible and rigid laryngoscopy was high (r = 0.852-0.893). The observed tumor extension was significantly larger when using NBI in both settings. The use of NBI during flexible laryngoscopy leads to upstaging (12%) and downstaging (2%) of the T classification.
CONCLUSIONS
NBI during flexible laryngoscopy could be an alternative to WLI rigid endoscopy. NBI improves visualization of tumor extension and accuracy of T staging.
LEVEL OF EVIDENCE
3 Laryngoscope, 131:E2222-E2231, 2021.
目的/假设：比较门诊环境下使用白光成像（WLI）和窄带成像（NBI）的纤维喉镜与全身麻醉下纤维喉镜对恶性肿瘤的检出和扩展的检测。
研究设计
前瞻性研究。
方法
233 例喉咽病变患者行纤维喉镜和硬性喉镜检查，均行 WLI 和 NBI。详细比较两种技术对恶性病变（n=132）扩展的检测。
结果
纤维内镜下 NBI 的灵敏度（92%）与硬性内镜下 WLI 的灵敏度（91%）相当。纤维镜和硬性镜之间的肿瘤扩展相关性很高（r=0.852-0.893）。在两种检查中使用 NBI 时，观察到的肿瘤扩展明显更大。在纤维喉镜下使用 NBI 可导致 T 分期上的升级（12%）和降级（2%）。
结论
纤维喉镜下使用 NBI 可以替代 WLI 硬性内镜检查。NBI 可提高肿瘤扩展的可视化程度和 T 分期的准确性。
证据水平
3 级喉镜，131：E2222-E2231，2021。
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