论文部分内容阅读
目的研究用自身荧光内镜在早期喉癌和癌前病变诊断中的应用价值。方法75例疑有早期喉癌及癌前病变的患者在显微喉镜下暴露喉腔,由短弧氙灯提供的过滤蓝光(波长380～460nm)激发检查部位的自身荧光,通过高清晰度摄像系统获取自身荧光图像并加以分析、诊断,图像储存并与组织病理学结果做比较。结果正常喉黏膜和轻度上皮非典型性增生显示典型的亮绿色荧光信号,中、高度上皮非典型性增生,原位癌和浸润癌呈现绿色荧光的减少、消失;自身荧光内镜可把高度非典型性增生和癌前病变与低度非典型性增生和炎性病变区别开来,敏感度可达97.8%,特异性为86.7%。假阴性结果(1例)是由重度的上皮过度角化所致;黏膜的炎症充血和瘢痕易于产生假阳性结果(4例)。结论自身荧光内镜图像技术是无创性诊断喉癌及其癌前病变的辅助性方法,操作简单,敏感度高,但存在一定的假阳性率。
Objective To study the value of autofluorescence endoscopy in the diagnosis of early laryngeal cancer and precancerous lesions. Methods Seventy 75 patients with early laryngeal carcinoma and precancerous lesions were exposed to laryngoscope under the laryngoscope and the autofluorescence of the examination site was stimulated by the filtered blue light (wavelength of 380-460nm) provided by the short arc xenon lamp. Through high-definition imaging The system acquires its own fluorescence images and analyzes them, diagnoses, images are stored and compared with histopathological findings. Results The normal laryngeal mucosa and mild epithelial atypical hyperplasia showed typical bright green fluorescence signal. The moderate and high epithelial atypical hyperplasia, in situ carcinoma and invasive carcinoma showed the decrease of green fluorescence and disappeared. The autofluorescence endoscopy could change the height Atypical hyperplasia and precancerous lesions are distinguished from low-grade atypical hyperplasia and inflammatory lesions with a sensitivity of 97.8% and a specificity of 86.7%. False negative results (n = 1) were due to severe hyperkeratosis of the epithelium; mucosal inflammation hyperemia and scarring were likely to produce false-positive results (n = 4). Conclusion Self-fluorescence endoscopy is a noninvasive method to diagnose laryngeal cancer and its precancerous lesions. It is easy to operate and has high sensitivity, but it has some false positive rate.