發(fā)布時間：2018-05-02 20:39

  本文選題：FICE + 喉癌前病變��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討喉部腫瘤智能分光比色技術(flexible spectral imaging color enhancement,FICE)特點及FICE內鏡在喉部腫瘤早期診斷中的應用價值方法:收集自2015年3月至2016年12月63例疑似喉部腫瘤的患者,使用EG-590ZW電子胃鏡,它具有白光內鏡(white light endoscopy,WLE)和FICE內鏡兩種觀察模式,分別對喉部病變進行觀察、攝圖并保存。通過對黏膜及黏膜下毛細血管形態(tài)及走形、病灶邊界,比較兩種觀察模式下圖像清晰度;比較兩種內鏡模式下正確診斷率;對比兩種模式下的喉癌前病變、喉癌的敏感性及特異性;FICE內鏡模式下對喉部病變血管分型。結果:1、FICE內鏡在血管形態(tài)、走形及病灶邊界的顯示上都明顯優(yōu)于普通白光內鏡((49)0.05)。2、在63例喉部腫物中共發(fā)現(xiàn)85個病灶,其中良性病變28個(包括慢性炎性、息肉、單純性增生),輕度不典型增生9個,中度不典型增生3個,重度不典型增生3個,原位癌6個,浸潤癌36個。FICE內鏡對喉癌病變的正確診斷率是91%,高于普通白光內鏡的68.2%,兩者比較差異有統(tǒng)計學意義((49)0.05);FICE內鏡對喉癌前病變及喉癌的敏感性92.4%,高于普通白光內鏡的74.6%,具有統(tǒng)計學意義((49)0.05);FICE內鏡對于喉癌前病變及喉癌的特異性91.8%,普通白光內鏡的87.8%((49)0.05),無統(tǒng)計學意義。3、FICE分級與病理診斷關系:Ⅰ型患者:息肉8例,Ⅱ型患者:慢性炎癥18例,息肉2例,其診斷對良性病變的敏感性為92.8%;Ⅲ型患者:輕度不典型增生8例,中度不典型增生3例,其診斷不典型增生的敏感性為100%,Ⅳ型患者:輕度不典型增生1例,中度不典型增生2例,重度不典型增生及原位癌6例,浸潤癌1例,差異有統(tǒng)計學意義((49)0.05);V型患者:浸潤癌占100%,其診斷浸潤癌的敏感性為97.2%(35/36)。結論:1、與普通白光模式相比,FICE模式對于病變的輪廓、黏膜層及黏膜下層微血管的形態(tài)及走形變化可清晰地顯現(xiàn)出來,增強病變識別度。2、FICE內鏡對喉癌前病變和喉癌病變診斷的正確率、敏感性,比普通白光模式具有明顯優(yōu)勢,從而增強內鏡在喉癌前病變和喉癌術前診斷和術后隨訪中的作用。3、通過FICE模式下對血管形態(tài)分型,可更早發(fā)現(xiàn)喉部腫瘤早期病變及微小病灶。
[Abstract]:Objective: to investigate the characteristics of flexible spectral imaging color enhancement technique and the value of FICE endoscopy in the early diagnosis of laryngeal neoplasms. From March 2015 to December 2016, 63 suspected laryngeal neoplasms were collected. Using EG-590ZW electronic gastroscope, it has two observation modes: White light endoscopy WLEand FICE endoscopy. The laryngeal lesions are observed, photographed and preserved respectively. By comparing the morphology and shape of the mucosal and submucosal capillary, the boundary of the lesion, the clarity of the image in the two observation modes, the correct diagnostic rate under the two kinds of endoscopic modes, and comparing the laryngeal precancerous lesions in the two modes, Sensitivity and specificity of laryngeal carcinoma in vascular classification of laryngeal lesions under nice endoscopy. Results the vascular morphology, anatomic shape and lesion boundary were obviously superior to those of common white light endoscopy in displaying vascular morphology, morphology and lesion boundary. 85 lesions were found in 63 laryngeal masses, of which 28 were benign lesions (including chronic inflammatory polyps, polyps). There were 9 mild atypical hyperplasia, 3 moderate atypical hyperplasia, 3 severe atypical hyperplasia and 6 carcinoma in situ. The correct diagnostic rate of invasive carcinoma 36. Nice endoscopy for laryngeal cancer lesions was 91, which was higher than that of ordinary white light endoscopy. The difference between them was statistically significant. The sensitivity of nice endoscopy to laryngeal precancerous lesion and laryngeal carcinoma was 92.4%, higher than that of ordinary white light endoscopy 74.6%. The specificity of nice endoscopy for laryngeal precancerous lesion and laryngeal carcinoma was 91.8%, while that of common white light endoscopy was 49.08%. There was no statistical significance. 3FICE grade had no relationship with pathological diagnosis: type 鈪，

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