窄带成像内镜在喉咽癌早期诊断中的应用

目的探讨喉咽癌内镜窄带成像（narrow band imaging,NBI）特点及NBI内镜在喉咽癌早期诊断中的应用价值。方法自2008年12月～2009年7月对46例喉咽癌患者使用具有普通白光和NBI两种观察模式的电子内镜进行咽喉部的检查。对发现的病灶分别评估白光模式和NBI模式下病变表面毛细血管形态和病变边界的清晰度,比较两种观察模式对喉咽癌的观察效果和病变的检出能力。结果在46例喉咽癌中共发现86个病灶,喉咽鳞状细胞癌在NBI内镜下表现为边界清楚的棕色区域,内部可见清晰的棕色斑点。在浅表型病灶中,NBI内镜在血管形态及病变边界的显示上都明显优于普通白光内镜（P〈0.001）,能够明显提高对重度不典型增生和原位癌的检出率（P〈0.05）。结论NBI内镜能够通过清晰显示黏膜表面的微细血管形态和病变边界提高对早期喉咽癌的检出能力。     

窄带成像内镜在鼻咽癌诊断中的价值

目的探讨窄带成像（narrow band imaging,NBI）内镜在鼻咽癌诊断中的价值。方法自2009年1月～2010年3月对怀疑有鼻咽部占位的240例患者使用具有NBI观察模式的电子内镜进行鼻咽部的检查。观察NBI模式下鼻咽部不同性质病变的黏膜表面微血管形态学特点。结果鼻咽癌在NBI模式下可见病变表面出现细树枝状或扭曲线条状的新生血管,血管线条清晰明显,呈棕褐色。NBI内镜对鼻咽癌诊断的敏感性、特异性、阳性预测值和阴性预测值分别为80.6%、91_7%、96.7%和61.1%。结论 NBI内镜通过识别黏膜表面微细血管的形态变化提高内镜在鼻咽癌早期诊断中的作用。     

窄带成像技术在喉癌及癌前病变诊断中的应用

目的探索窄带成像技术（narrow band imaging,NBI）在喉癌及癌前病变诊断中的应用价值。方法138例喉肿块患者分别行普通白光内镜及NBI检查并取活检做病理学分析。对69例癌前及浸润癌患者的NBI形态进行观察与统计。结果NBI在发现喉癌病变的敏感性、阴性预测值及检出率均高于普通自光内镜。上皮内乳头状毛细血管袢（intraepithelial papillary capillary loop,IPCL）形态分型与病变的病理组织学密切相关。Ⅲ型可预示不典型增生病变,原位癌与浸润癌均可表现出Ⅳ型血管形态,Ⅴ型可诊断浸润癌。结论NBI技术可提高喉癌患者的检出率,降低漏诊率,在喉癌诊断中有重要价值。NBI镜下血管形态有助于对喉癌及癌前病变的诊断。     

窄带成像内镜在口腔癌及癌前病变诊断中的应用北大核心CSCD

目的探讨窄带成像(narrow band imaging,NBI)内镜在口腔癌及癌前病变诊断中的应用价值。方法收集厦门大学附属第一医院2016年7月至2017年10月85例口腔黏膜病变患者的临床资料,其中男47例,女38例;年龄12~83岁,中位年龄58岁。85例患者共取得口腔病变组织144个;应用NBI及白光内镜对其行口腔检查,依据倪晓光咽喉病变NBI分型、观察口腔病变的NBI表现及其与相应病理结果之间的关系。应用SPSS 22.0软件进行统计学分析,计算NBI内镜和白光内镜诊断的灵敏度、特异度、阳性预测值、阴性预测值以及与病理结果的符合度。结果NBI内镜对口腔恶性病变诊断的灵敏度为96.5%,特异度为98.3%,阳性预测值为98.8%,阴性预测值为95.1%,NBI内镜结果与病理结果具有高度一致性(kappa=0.943,P<0.01);白光内镜诊断的灵敏度为81.2%,特异度为98.3%,阳性预测值为98.6%,阴性预测值为78.4%,白光内镜结果与病理结果具有较好的一致性(kappa=0.765,P<0.01)。NBI内镜能较普通白光内镜更准确地检出口腔恶性病变(P<0.01)及癌前病变(P<0.01)。倪晓光口腔病变NBI分型与其病理结果之间相关(r=0.836,P<0.01)。结论NBI内镜能较白光内镜更准确地检出口腔癌病灶;倪晓光的NBI分型标准对口腔癌及癌前病变的早期诊断具有重要意义。     

窄带成像内镜在鼻咽癌诊断中的应用价值

目的　探讨窄带成像技术（n a r row b a nd imaging,NBI）在鼻咽部恶性病变诊断中的应用价值。方法　2014年6月～2015年8月行电子鼻咽喉镜发现鼻咽部存在可疑恶性病变患者共52例,分别行普通白光及NBI内镜检查,分别记录图片资料预测病变性质,并行病理活检,以病理诊断为金标准比较两种模式诊断的准确率。结果  在52例鼻咽部病变患者中,病理诊断鼻咽部恶性病变46例（88.46%）,非恶性病变6例（11.54%）。NBI内镜对鼻咽部恶性病变的正确诊断率是86.54%（45/52）,高于普通白光内镜的69.23%（36/52）,两者比较差异有统计学意义（χ2=4.522,P <0.05)。NBI内镜诊断鼻咽癌的敏感性97.83%（45/46）,高于普通白光内镜的78.26%（36/46）,两者比较 差异有统计学意义（χ2=8.364,P <0.05）。结论　NBI内镜在鼻咽癌的诊断及靶向指导活检方面较普通白光内镜具有更高的应用价值,有望成为诊断鼻咽部病变的重要手段之一。     

窄带成像技术在诊断早期喉癌及癌前病变中的应用研究

目的　探讨窄带成像（narrow band imaging，NBI）技术在诊断早期喉癌病变中的临床应用。方法　选取2019年1月~2020年12月蚌埠医学院第一附属医院耳鼻咽喉头颈外科就诊怀疑喉部恶性肿瘤或癌前病变的129例患者，应用NBI内镜对可疑病灶进行检查，判断病变性质后行病理学检查，并与白光内镜的结果进行比较。结果　NBI内镜和白光内镜的准确率、敏感性、阴性预测值分别为96.12%vs 86.05%、97.37% vs 86.84%、81.25% vs 44.44%，差异有统计学意义；病变颜色方面比较，差异有统计学意义 （χ2=178.889，P <0.05）；病变黏膜表面的微血管形态结构判别良恶性比较，差异有统计学意义（χ2=135.502，P <0.05）；判断病变范围方面比较，差异有统计学意义（χ2=91.899，P<0.05）。结论　NBI内镜比白光内镜能更好的观察到病变黏膜表面细微结构变化，对发现早期喉癌及癌前病变的能力及诊断的准确性较高，利于确定活检部位、早期诊断并确定手术安全边界，可用于喉癌的无创筛查和早期诊断。     

窄带成像内镜在喉癌诊断中的应用

目的 探讨窄带成像(narrow band imaging,NBI)内镜在喉癌及其癌前病变诊断中的应用价值.方法 自2008年12月至2009年7月对122例怀疑有喉癌或癌前病变的患者选用具有普通白光和NBI两种观察模式的电子内镜进行咽喉部的检查.对发现的病灶依次使用白光和NBI模式进行分类和病灶性质的判断,以病理诊断作为金标准,比较两种观察模式对喉癌的诊断作用.结果 122例患者中共发现了149个病灶,其中息肉16个,炎性反应7个,单纯性增生24个,轻度不典型增生17个,中度不典型增生6个,重度不典型增生6个,原位癌9个,浸润癌64个.NBI内镜对喉部病变的正确诊断率是90.6%(135/149),高于普通白光内镜的75.2%(112/149),两者比较差异有统计学意义(x~2=12.514,P<0.001).NBI内镜对喉癌诊断的敏感性为93.2%(68/73),高于普通白光内镜的68.5%(50/73,x~2=14.317,P<0.001).结论 NBI内镜通过识别黏膜表面微细血管形态变化提高对喉癌诊断的敏感性和喉部病变诊断的正确率,从而增强内镜在喉癌术前诊断和术后随访中的作用.     

窄带成像技术下鼻咽癌黏膜微血管形态学变化分析

目的探讨窄带成像技术(narrow band imaging,NBI)下鼻咽癌黏膜微血管形态的特征性表现。方法选取我科2009年12月～2010年9月在门诊行电子鼻咽喉内镜检查,NBI模式下鼻咽局部疑为癌变并行活检的患者94例,根据局部是否隆起将上述患者分为平坦组与隆起组,计算NBI技术对上述两组患者鼻咽癌诊断的阳性预测值,并作统计学比较,评估NBI模式下鼻咽癌与非癌变黏膜微血管的形态学特点。结果 NBI模式下鼻咽黏膜血管分为黏膜下血管(submucosal vessels,SV)、树枝状血管(branching vessels,BV)以及上皮内乳头状毛细血管袢(intraepithelial papillary capillary loop,IPCL)3类。黏膜下层血管有2种形式,即正常型和扩张型;树枝状血管有3种形式,即正常型、僵直扩张型及弯曲扩张型;上皮内乳头状毛细血管袢有3种形式,即密集点状扩张型、疏松点状扩张型及迂曲扩张型。各组黏膜微血管形态均有所不同。在本组资料中NBI模式对鼻咽癌诊断的阳性预测值为80.9%,其中平坦组为37.5%,隆起组为95.7%,两者差异有统计学意义(P<0.05)。结论窄带成像技术下鼻咽癌黏膜微血管形态学变化具有特异性,提高对上述血管形态变化的认识可为鼻咽癌的早期诊断提供可靠的依据。     

鼻咽癌内镜窄带成像特征观察

目的 观察鼻咽癌内镜窄带成像(narrow band imaging, NBI)特征。方法 83例鼻咽肿物患者,采用电子鼻咽喉镜及NBI检查,记录NBI模式下鼻咽病变血管颜色、数量及形态特征并进行评分,所有病例同时行鼻咽活检。比较分析鼻咽癌及鼻咽炎两组病例NBI特征及评分。结果 确诊鼻咽癌34例,慢性鼻咽炎49例。鼻咽癌患者电子镜下鼻咽NBI特征表现为血管颜色以墨绿色及棕褐色为主(79.4%),血管密集融合(47.1%),血管扭曲,血管边界模糊(44.1%),与鼻咽炎组比较,统计学意义非常明显(P<0.01)。NBI评分8分及以上可临床诊断为鼻咽癌。结论 鼻咽癌具有特定的NBI特征,可作为鼻咽癌临床内镜诊断指标。     

电子喉镜联合窄带成像技术对喉部早期恶性病变的诊断价值北大核心CSCD

目的探讨电子喉镜联合窄带成像技术(narrow band imaging,NBI)诊断喉部早期恶性肿瘤及癌前病变的应用价值。方法选取2016年12月至2017年5月以喉部不适为主诉的患者共50例,男41例,女9例,平均年龄59.3±13.2岁,分别用白光及NBI电子喉镜进行喉部检查,并对每一例患者进行颈部增强CT检查,分别根据白光、NBI内镜和增强CT预估病灶的良恶性,以手术或活检病理结果作为诊断金标准进行对照分析。结果50例患者共发现病灶56个,其中,病理检查为良性病变36个,恶性肿瘤20个;白光和NBI内镜的敏感性分别为60.0%和90.0%(χ~2=4.80,P=0.03),NBI内镜和增强CT检查的准确率分别为92.9%和75.0%(χ~2=6.62,P=0.01),敏感性分别为90.0%和60.0%(χ~2=4.80,P=0.03),差异有统计学意义(均为P<0.05)。结论 NBI内镜能更好的观察到黏膜表面细微结构的变化,对于早期喉癌,其发现病变的能力及诊断的准确性均高于普通白光喉镜和增强CT检查,有利于早期诊断、确定活检部位和手术边界。     

The value of narrow band imaging for early detection of laryngeal cancer

We evaluate the value of laryngoscopy using narrow band imaging (NBI) system in the diagnosis of precancerous and cancerous laryngeal lesions. Thirty-four patients were suspected of having a total of 35 precancerous or cancerous laryngeal lesions among patients receiving conventional white-light laryngoscopy. All 34 patients underwent laryngoscopy with NBI system to determine whether those lesions were malignant before biopsy procedure. The diagnostic criteria of malignancy by NBI view was the presence of demarcated brownish area with scattered brown spots in the lesion. Histopathologic results were retrospectively compared with results of determination of malignancy made by NBI view. Of the 23 lesions histopathologically proved to be malignancies, 21 lesions were classified as malignant by NBI view. Sensitivity and specificity for the diagnosis of malignancy by means of NBI view compared with histopathologic results were 91.3% for sensitivity and 91.6% for specificity. NBI endoscopy seems to be a very promising diagnostic tool in the diagnosis of laryngeal malignant disease.     

窄带成像内镜在喉癌前病变诊断中的应用价值[论著]

目的　探讨窄带成像（narrow band imaging,NBI）内镜在诊断喉癌前病变中的应用价值。方法　选取2019年1月～2020年6月新疆医科大学第二附属医院耳鼻咽喉头颈外科以声音嘶哑及咽喉部不适为主诉就诊,由门诊专科技术人员分别在NBI和普通电子喉镜两种不同内镜模式下进行咽喉部检查后,再行喉部CT检查收治入院患者共90例,男55例,女35例,年龄（45.2±15.3）岁。所有患者根据检查结果预先评估肿瘤性质后,再以术后病理诊断为“金标准”进行对照分析。结果　90例患者中有23例确诊恶性肿瘤,67例为良性肿瘤（其中喉癌前病变38例）。在血管清晰度及图像清晰度两个方面,两种内镜模式检查结果组间差异均有统计学意义（χ2分别为3.989、4.012,P＜0.05）。在良性肿瘤、喉癌前病变及喉癌的诊断上,NBI内镜的准确率明显高于普通电子喉镜。而在良性肿瘤方面,差异无统计学意义,但在癌前病变及喉癌的诊断及 总检出率中,差异均有统计学意义（P＜0.05）。结论　NBI内镜对喉癌前病变的检出率更高于普通电子喉镜,尤其在发现微小病灶方面更有优势,对及早发现早期病变、提高准确率有着重要的意义。     

Classification of nasopharyngeal microvessels detected by narrow band imaging endoscopy and its role in the diagnosis of nasopharyngeal carcinoma

Conclusions: The new NBI classification of nasopharyngeal mucosal microvessels was helpful in differential diagnosis for benign and malignant lesions of the nasopharyngeal region. NBI endoscopy facilitates the detection of superficial nasopharyngeal lesions and might enable early diagnoses of NPC.

Objectives: To propose a new microvessel diagnostic classification using narrow band imaging (NBI) endoscopy and to investigate the role of an NBI classification in the diagnosis of nasopharyngeal carcinoma (NPC).

Methods: Between January 2009 and December 2010, a total of 290 patients with a suspected nasopharyngeal tumor were enrolled in this study. The NBI endoscopic system was used to examine the nasopharynx. Each lesion was observed by NBI endoscopy and judged according to the detailed morphologic findings of epithelial microvessels. The superficial microvessel patterns were classified into five types (types I–V). The diagnostic effectiveness of NBI for benign and malignant nasopharyngeal lesions was evaluated.

Results: Approximately 93.5% (29/31) of lymphoid hyperplasia appeared as the type II microvessel pattern under NBI endoscopy, whereas 96.2% (51/53) of nasopharyngeal radiation-induced inflammation exhibited the type III or IV microvessel pattern. The characteristics of NPC under NBI endoscopy mainly appeared as a type V microvessel pattern (79.5%, 167/210), and the sensitivity, specificity, predictive value (PPV), and negative predictive value (NPV) of type V in the diagnosis of NPC were 79.5%, 91.3%, 96.0%, and 62.9%, respectively. NBI endoscopy could significantly improve the detection of superficial lesions (χ^2?=^?12.789, p?=?.000).     

Narrow band imaging in early diagnosis of laryngopharyngeal malignant and premalignant lesions

Objectives: (1) To assess the diagnostic accuracy of narrow-band imaging (NBI) in the assessment of benign, premalignant, and malignant vocal fold lesions. (2) To evaluate the diagnostic value of NBI in detection of recurrence in upper aero-digestive tract malignancy.Methods: This was a prospective, observational study done between December 2018- November 2019 in the Department of Otolaryngology. One hundred six patients of suspected benign, premalignant, malignant lesions of larynx and hypopharynx along with recurrence cases of upper aerodigestive tract malignancy who have completed chemoradiation therapy. All patients were subjected to white light endoscopy (WLE), NBI, and biopsy for histopathological diagnosis. In WLE, laryngeal lesions were classified into three types: malignant, suspected malignant, and benign. NBI images were classified into 5 types based on the intrapapillary capillary loop (IPCL) patterns: Type I-IV were considered benign and Type V lesion was considered malignant. At the end, WLE and NBI findings were correlated with histopathological reports.Results: The diagnostic accuracy of NBI in diagnosing benign, premalignant, and malignant lesions is significantly better than WLE. The sensitivity of NBI in detecting malignant lesions is significantly greater than WLE. NBI has proved to be of great value in identifying lesions that could be missed by WLE alone, as combined sensitivity of NBI and WLE is significantly higher than WLE alone.Conclusion: NBI is an excellent technique for early detection of laryngopharyngeal malignancies with significantly higher sensitivity than WLE alone.     

光学增强内镜在喉癌前病变及喉癌诊断中的初步应用

目的 探讨光学增强内镜(optical enhancment,OE)对喉癌前病变及喉癌诊断的初步应用价值.方法 选取2018年5月～2019年12月检查发现喉肿物患者共121例(162侧),应用光学增强内镜的3种观察模式(普通白光模式、OE模式1、OE模式2)进行喉部病变观察,观察喉部病变两种OE模式下表现及其与病理结...     

Evaluating hypopharyngeal carcinoma using narrow band imaging and oxygen-injected laryngoscope: New technique

ObjectiveTo evaluate the diagnostic value of narrow band imaging (NBI) endoscopic classification for hypopharyngeal lesions and to lay the groundwork for practical applications of oxygen-injected laryngoscope for hypopharyngeal carcinoma (HC).MethodsA total of 140 subjects with suspected 146 hypopharyngeal lesions were selected for pathological examination. Subsequently, NBI and white light imaging (WLI) endoscopy were performed to observe and classify lesions into 7 types according to our modified NBI classification. Pathological results were used as the gold standard to assess the diagnostic value of the NBI classification. The value of oxygen-injected laryngoscope for accurate assessment of lesion extension was evaluated based on the exposure of hypopharyngeal lesions before and after use.ResultsThe accuracy, sensitivity, and negative predictive value of NBI endoscopy in diagnosing hypopharyngeal lesions were 95.9 %, 96.7 %, and 84.6 %, respectively, which were higher than those of WLI mode (p < 0.05). NBI endoscopy was more accurate than WLI in diagnosing malignant lesions (p < 0.05), especially for high-grade dysplasia (HGD) (p < 0.05). There was remarkable consistency between NBI classification and pathological results (Kappa = 0.855). Type Va and type Vb-c accounted for 72.7 % and 92.8 % of HGD and invasive carcinoma, respectively. Moreover, the oxygen-injected laryngoscope was found to provide a more accurate assessment of HC extension (P < 0.001).ConclusionWe propose a more appropriate NBI endoscopic classification for hypopharyngeal lesions, which can effectively improve diagnostic accuracy, especially for the early diagnosis of hypopharyngeal cancer. Moreover, the application of oxygen-injected laryngoscope is essential for the accurate assessment of HC and has a high clinical utility.