窄带成像技术普通内镜对喉恶性病变的诊断价值

目的　探讨窄带成像技术（n a r row b a nd imaging,NBI）普通内镜对喉恶性病变诊断的应用价值。方法 自2013年2月～2014年12月内镜检查发现425例喉肿物患者,观察NBI模式普通内镜下喉肿物病变区黏膜形态及血管变化,进行分型诊断,将NBI内镜诊断结果与病理结果对比分析。结果　NBI普通内镜对喉恶性病变诊断的敏感 性为80.43%,特异性为97.10%,阳性预测值77.08%,阴性预测值97.61%。结论　NBI普通内镜通过观察病变区黏膜形态及血管变化在喉恶性病变的诊断中有着良好的应用价值。     

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。     

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病变诊断中的应用初探

目的 探讨窄带成像(narrow band imaging,NBI)内镜在鼻咽病变诊断中的应用价值.方法自2009年12月至2010年4月对124例鼻咽病变患者使用具有普通白光与NBI两种观察模式的电子鼻咽喉镜进行检查,并行病理活检,评估NBI模式下鼻咽病变黏膜及黏膜表面血管的形态学特点.结果 本组病例经病理活检证实乳头状瘤1例,淋巴滤泡增生并慢性炎性反应87例,鼻咽囊肿11例,鼻咽癌25例.根据病变病理的不同,NBI模式下病变局部黏膜的颜色及黏膜表层血管形态明显不同,其中黏膜颜色深度可分为4级,分别记录为(+)～(++++),其中(+)为淡红色,(++)为暗红色,(+++)为紫红色,(++++)为蓝色或蓝黑色.NBI模式下乳头状瘤、鼻咽囊肿、淋巴滤泡增生并慢性炎性反应分别表现为(+)、(++)与(+++),未见异常血管增生;鼻咽癌表现为(+++)～(++++),异常血管增生明显.结论 NBI技术对于预测鼻咽病变的病理结果有着良好的临床应用价值.

Abstract：

Objective To evaluate the value of narrow band imaging (NBI) endoscopy in the diagnosis of nasopharyngeal lesions. Methods Between December 2009 and April 2010, a total of 124 patients with nasopharyngeal lesions were examined with electronic nasopharyngolaryngoscope equipped with the white light mode and NBI mode. The biopsies of nasopharyngeal lesions were done in all patients. The characteristics of morphologies of mucosa and mucosal superficial vessels of each lesion under NBI mode were evaluated. Results Of all cases, there were 1 of papilloma, 87 of lymphoid follicular hyperplasia and chronic inflammation, 11 of nasopharyngeal cysts, and 25 of nasopharyngeal carcinoma. According to the pathological results, the morphologies of nasopharyngeal lesions under NBI mode were quite different. The color depth of the mucosa could be divided iuto four types: light red ( + ), dark red ( + + ), prunosus ( + + + ), and blue or blue black ( + + + + ). Under NBI, the color depths were ( + ) in papilloma,( + + ) in nasopharyngeal cysts, and ( + + + ) in lymphoid follicular hyperplasia and chronic inflammation, without abnormal vessels. The color depths were ( + + + ) - ( + + + + ) in nasopharyngeal cancer, with abnormal vessels. Conclusion NBI has a potential ability to predict pathological results of nasopharyngeal lesions.     

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.     

鼻内镜检查在鼻咽癌诊断中的应用价值

目的评价鼻内镜检查对鼻咽癌的诊断价值. 方法对耳鼻咽喉科就诊的2 300例患者施行经鼻腔鼻内镜下鼻咽部检查,连接影像工作系统记录图像文字资料,可疑病变在鼻内镜直视下取活检. 结果 28例患者经鼻内镜检查及活检病理诊断为鼻咽癌,其中25例1次活检明确诊断,3例2次活检明确诊断.鼻内镜检查前行间接鼻咽镜检查的病例中,23例发现病变,5例阴性.CT扫描病例中25例显示异常,3例阴性. 结论鼻内镜检查光亮度强,分辨率高,能早期发现鼻咽部黏膜细微病变.鼻内镜直视下取活检准确率高.该检查对鼻咽癌诊断、鼻咽癌放疗后监控和病例随访具有重要价值.     

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).     

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。     

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.     

Endoscopic diagnosis value of narrow band imaging Ni classification in vocal fold leukoplakia and early glottic cancer

ObjectivesTo explore the diagnostic value and the correlation between histological diagnosis and the Ni classification under narrow band imaging (NBI) for vocal fold leukoplakia (VFL) and early glottic cancer.MethodsA total of 91 patients with 119 vocal fold lesions were selected from January 2017 to May 2020. All these patients were subsequently examined by white light imaging (WLI) and NBI endoscopy, and then all lesions were classified by the Ni classification according to the characteristics of intraepithelial papillary capillary loop (IPCL) observed. The gold standard of diagnosis was histopathological results. Eventually, the chi-square and kappa test were applied, respectively, to evaluate the diagnostic value of NBI endoscopy and the consistency of Ni classification and pathological results.ResultsThe accuracy and sensitivity of NBI endoscopy were significantly higher than that of WLI endoscopy (P < 0.05). For the diagnosis of precancerous lesions under the NBI, the sensitivity, specificity, positive and negative predictive value were 69.6% (16/23), 90.6% (87/96), 64.0% (16/25) and 92.6% (87/94), which for malignant lesions were 84.4% (65/77), 92.9% (39/42), 95.6% (65/68) and 76.5% (39/51). Moreover, for patients with low-grade intraepithelial neoplasia (mild and moderate dysplasia), type IV lesions accounted for the most (69.6 vs 30.4%; χ² = 36.961, P < 0.001). For high-grade intraepithelial neoplasia or carcinoma in situ, type Va lesions were predominant (χ² = 30.526, P < 0.001), while type Vb and Vc lesions were dominant in invasive carcinoma (χ² = 64.373, P < 0.001). Besides, the kappa test revealed that there was a high consistency between Ni classification and pathological diagnosis (Kappa = 0.667, P < 0.001).ConclusionsThe Ni classification can improve the diagnosis accuracy of vocal fold lesions which enables clear visualization of mucosal microvasculature. This is essential for the early diagnosis of VFL and early glottic cancer during routine endoscopic examination.