自体荧光喉镜对早期喉癌及癌前病变的诊断价值

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摘要目的：研究自体荧光喉镜对早期喉癌及癌前病变的诊断价值。方法：对2014年7月至2016年7月在温州医科大学附属第一医院接受治疗的122例早期喉癌或癌前病变患者同时进行白光和自体荧光喉镜检查，以组织病理学诊断为金标准，比较二者敏感度和特异度。结果：122例患者中组织病理诊断为高、低危病灶分别为95例和27例，自体荧光喉镜和普通白光喉镜分别检出82例和66例高危病灶，灵敏度分别为86.3%和69.5%（P=0.005），特异度分别为51.9%和63.0%（P=0.409）。自体荧光喉镜发现了20例被普通白光喉镜漏诊的早期喉癌或癌前病变。喉癌或癌前病变在自体荧光喉镜下表现为被绿色荧光包围着红紫色区域。结论：自体荧光喉镜有助于喉癌的早期诊断，为喉癌的活检和手术切除提供指导。

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	吴贤敏
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	陈晓云

关键词 ：喉肿瘤, 自体荧光喉镜, 普通白光喉镜, 诊断

Abstract：Objective: To study the diagnostic value of autologous fluorescence laryngoscope for early laryngeal carcinoma and precancerous lesions. Methods: A total of 122 patients, who were suspected with early laryngeal cancer or precancerous lesion and treated at the First Affiliated Hospital of Wenzhou Medical University from July 2014 to July 2016, were examined by both white light and autofluorescence laryngoscopy. The sensitivity and specificity of the two methods were compared based on histopathological diagnosis. Results: The histopathological diagnosis of high and low risk lesions were 95 and 27 respectively. There were 82 and 66 high-risk lesions detected by autofluorescence laryngoscope and ordinary white laryngoscope respectively. The sensitivity of autologous fluorescence laryngoscope and ordinary white laryngoscope was 86.3% and 69.5% (P=0.005) respectively, and the specificity was 51.9% and 63.0% respectively (P=0.409). Twenty cases of early laryngeal cancer or precancerous lesions which had been missed by ordinary white light laryngoscope were detected by autologous fluorescence laryngoscope. Precancerous lesions or precancerous lesions appeared to be surrounded by green fluorescence under autologous fluorescence laryngoscope. Conclusion: Autologous fluorescence laryngoscope is helpful for early diagnosis of laryngeal carcinoma and provides guidance for biopsy and surgical resection of laryngeal carcinoma.

Key words： laryngeal neoplasms autofluorescence laryngoscopy white-light laryngoscopy diagnosis

基金资助:浙江省公益技术研究社会发展项目（2013C33241）；温州市公益性科技计划项目（Y20110090）。

通讯作者: 陈晓云，副主任医师，Email：chenxiaoyun2816@ 163.com。

作者简介: 吴贤敏（1982-），男，浙江瑞安人，主治医师，博士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I8/587

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