窄带成像技术在咽喉肿瘤诊治中的应用

doi:10.6040/j.issn.1673-3770.0.2018.174

摘要/Abstract

摘要： 咽喉部恶性肿瘤是一种临床发病率低,发现时已到晚期,五年生存率低的一种疾病。对于如何提高咽喉部恶性肿瘤的早期发现这一问题,严重困扰着耳鼻喉科医师。目前咽喉部最常用的检查是白光电子喉镜。随着窄带电子喉镜(NBI)的出现,通过观察咽喉部黏膜及黏膜下毛细血管袢的形态,相对于普通白光电子喉镜,为早期发现咽喉部恶性肿瘤提供了可能性,同时在术中应用做到微创治疗及术后随访均起到重大作用。现就从NBI的起源原理,在咽喉恶性肿瘤中的应用优点、难点、临床应用发展前景等方面综述NBI技术在咽喉恶性肿瘤疾病中的应用。

关键词: 窄带成像技术, 咽喉肿瘤, 诊断治疗

Abstract: Malignant tumors of the pharynx and larynx have low clinical incidence, and are often terminal when discovered, with a low 5-year survival rate. The early detection of malignant tumors is a serious challenge for otolaryngologists. White-light electronic laryngoscopy has been the most commonly performed examination of the pharynx and larynx. With advances in technology, narrow-band imaging(NBI)electronic laryngoscopy now enables earlier detection of malignant tumors of the pharynx and larynx in contrast to that with ordinary white light laryngoscopy. The ability to demonstrate capillary loop morphology in the mucous membranes and submucous membranes of the throat makes minimally invasive treatment possible. NBI also plays a significant role in postoperative follow-up. This paper reviews the application of NBI in the management of tumors of the pharynx and larynx, and examines the origins, principles, advantages, disadvantages, and prospects for clinical application.

Key words: Narrow-band imaging, Pharynx and larynx cancer, Diagnosis and treatment

中图分类号:

R767.04

陈立晓,蒋锐,於子卫. 窄带成像技术在咽喉肿瘤诊治中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 104-108.

CHEN Lixiao, JIANG Rui, YU Ziwei. Narrow-band imaging in diagnosis and treatment of tumors of the pharynx and larynx[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 104-108.

参考文献

[1] Pesko P, Sabljak P, Bjelovic M, et al. Surgical treatment and clinical course of patients with hypopharyngeal carcinoma[J]. Dis Esophagus, 2006, 19(4):248-253.
[2] Triboulet JP, Mariette C, Chevalier D, et al. Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases[J]. Arch Surg, 2001, 136(10):1164-1170.
[3] Iizuka T, Kikuchi D, Hoteya S, et al. Endoscopic submucosal dissection for treatment of mesopharyngeal and hypopharyngeal carcinomas[J]. Endoscopy, 2009, 41(2):113-117.
[4] 张平,董卫国,汤绍迁. 电子内镜窄带成像技术与智能分光比色技术的对比研究[J]. 中国医疗设备, 2009, 24(11):55-57, 61. ZHANG Ping, DONG Weiguo, TANG Shaoqian. Comparative research of the electronic endoscopy technology between narrow-band imaging and fuji intelligent chromo endoscopy[J]. Chin Med Dev, 2009, 24(11):55-57, 61.
[5] Yagishita A, Fujii S, Yano T, et al. Endoscopic findings using narrow-band imaging to distinguish between basal cell hyperplasia and carcinoma of the pharynx[J]. Cancer Sci, 2014, 105(7):857-861.
[6] Piazza C, Dessouky O, Peretti G, et al. Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature[J]. Acta Otorhinolaryngol Ital, 2008, 28(2):49-54.
[7] 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学, 2013(1):24-36. DOI:10.3969/j.issn.1008-7125.2013.01.007.
[8] Kim KO, Ku YS. Is image-enhanced endoscopy useful for the diagnosis and treatment of gastrointestinal tumor?[J]. Clin Endosc, 2013, 46(3):248-250.
[9] Carns J, Keahey P, Quang T, et al. Optical molecular imaging in the gastrointestinal tract[J]. Gastrointest Endosc Clin N Am, 2013, 23(3):707-723.
[10] Goda K, Dobashi A, Tajiri H. Perspectives on narrow-band imaging endoscopy for superficial squamous neoplasms of the orohypopharynx and esophagus[J]. Dig Endosc, 2014, 26(S1):1-11.
[11] 王芳军,高昳,赵可,等. 窄带成像放大内镜在Barrett食管随访监测中的应用价值[J]. 中华消化内镜杂志, 2016, 33(11):764-768. WANG Fangjun,GAO Yi,ZHAO Ke, et al. The value of NBI-ME for targeting biopsy in the follow-up of Barrett esophagus[J]. Chin J Digest Endos, 2016, 33(11):764-768.
[12] Sharma P, Hawes RH, Bansal A, et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barretts oesophagus: a prospective, international, randomised controlled trial[J]. Gut, 2013, 62(1):15-21.
[13] Yip HC, Chiu PW. Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus[J]. J Thorac Dis, 2017, 9(S8):689-696.
[14] 孔亮,段华. 窄带光成像技术在内镜诊断中的应用[J]. 中国微创外科杂志, 2013, 13(12):1140-1144.
[15] Stevens SM, Johnson EA, Pfau PR, et al. Visual evaluation of the larynx and hypopharynx during esophagogastroduodenoscopy: a safety and feasibility study[J]. Surg Endosc, 2015, 29(5):1209-1215.
[16] Machida H, Sano Y, Hamamoto Y, et al. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study[J]. Endoscopy, 2004, 36(12):1094-1098.
[17] Muto M, Nakane M, Katada C, et al. Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites[J]. Cancer, 2004, 101(6):1375-1381.
[18] Watanabe A, Hosokawa M, Taniguchi M, et al. Periodic pharyngolaryngoscopy detects early head and neck cancer and improves survival in esophageal cancer[J]. Ann Thorac Surg, 2003, 76(5):1699-1705.
[19] Chang C, Lin WN, Hsin LJ, et al. Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings[J]. Laryngoscope, 2016, 126(12):2764-2769.
[20] Watanabe A, Taniguchi M, Tsujie H, et al. The value of narrow band imaging endoscope for early head and neck cancers[J]. Otolaryngol Head Neck Surg, 2008, 138(4):446-451.
[21] Kulapaditharom B, Boonkitticharoen V. Performance characteristics of fluorescence endoscope in detection of head and neck cancers[J]. Ann Otol Rhinol Laryngol, 2001, 110(1):45-52.
[22] Watanabe A, Taniguchi M, Tsujie H, et al. The value of narrow band imaging for early detection of laryngeal cancer[J]. Eur Arch Otorhinolaryngol, 2009, 266(7):1017-1023.
[23] Hayashi T, Muto M, Hayashi R, et al. Usefulness of narrow-band imaging for detecting the primary tumor site in patients with primary unknown cervical lymph node metastasis[J]. Jpn J Clin Oncol, 2010, 40(6):537-541.
[24] Muto M, Minashi K, Yano T, et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial[J]. J Clin Oncol, 2010, 28(9):1566-1572.
[25] 倪晓光,贺舜,徐震纲,等. 窄带成像内镜在喉癌诊断中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(2):143-147. NI Xiaoguang, HE Shun, XU Zhengang, et al. Application of narrow band imaging endoscopy in the diagnosis of laryngeal cancer[J]. Chin J Otorhinolaryngol Head Neck Surg, 2010, 45(2):143-147.
[26] 范大川,姚宪义,李慧军. 电子喉镜窄带成像技术在喉部病变诊断中的价值[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(3):134-136.
[27] 陈斌,郑亿庆,张志钢,等. 窄带成像内镜在鼻咽病变诊断中的应用初探[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(1):50-53. CHEN Bin, ZHENG Yiqing, ZHANG Zhigang, et al. Application of narrow band imaging endoscopy in the diagnosis of nasopharyngeal lesions[J]. Chin J Otorhinolaryngol Head Neck Surg, 2011, 46(1):50-53.
[28] 宋富存,杨阳,刘吉祥. 窄带成像内镜在鼻咽癌诊断中的应用价值[J]. 中国耳鼻咽喉头颈外科, 2016, 23(10):573-577. SONG Fucun, YANG Yang, LIU Jixiang. Application of narrow-band imaging endoscopy in diagnosis of nasopharyngeal carcinoma[J]. Chin Arch Otolaryngol Head Neck Surg, 2016, 23(10):573-577.
[29] Tirelli G, Piovesana M, Gatto A, et al. NBI utility in the pre-operative and intra-operative assessment of oral cavity and oropharyngeal carcinoma[J]. Am J Otolaryngol, 2017, 38(1):65-71.
[30] Carta F, Sionis S, Cocco D, et al. Enhanced contact endoscopy for the assessment of the neoangiogenetic changes in precancerous and cancerous lesions of the oral cavity and oropharynx[J]. Eur Arch Otorhinolaryngol, 2016, 273(7):1895-1903.
[31] Tanaka S, Morita Y, Fujita T, et al. Clinicopathological characteristics of abnormal micro-lesions at the oro-hypopharynx detected by a magnifying narrow band imaging system[J]. Dig Endosc, 2012, 24(2):100-109.
[32] Vu A, Farah CS. Narrow band imaging: clinical applications in oral and oropharyngeal cancer[J]. Oral Dis, 2016, 22(5):383-390.
[33] Vu AN, Farah CS. Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: a systematic review[J]. Oral Oncol, 2014, 50(5):413-420.
[34] Muto M, Satake H, Yano T, et al. Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer[J]. Gastrointest Endosc, 2011, 74(3):477-484.
[35] Nakayama M, Katada C, Mikami T, et al. A clinical study of transoral pharyngectomies to treat superficial hypopharyngeal cancers[J]. Jpn J Clin Oncol, 2013, 43(8):782-787.
[36] Plaat B, Zwakenberg MA, van Zwol JG, et al. Narrow-band imaging in transoral laser surgery for early glottic cancer in relation to clinical outcome[J]. Head Neck, 2017, 39(7):1343-1348.
[37] Zabrodsky M, Lukes P, Lukesova E, et al. The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy[J]. Biomed Res Int, 2014:175398.
[38] 张颖,段华,孔亮,等. 窄带成像宫腔镜在诊断子宫内膜癌及内膜非典型增生中的价值[J]. 中国微创外科杂志, 2012, 12(6):481-484. ZHANG Ying, DUAN Hua, KONG Liang, et al. Narrow-band imaging hysteroscopy for the diagnosis of endometrial cancer and endometrial atypical hyperplasia[J]. Chin J Mini Invas Surg, 2012, 12(6):481-484.
[39] 倪晓光,贺舜,高黎,等. 窄带成像内镜在喉咽癌早期诊断中的应用[J]. 中国耳鼻咽喉头颈外科, 2009, 16(10):550-554. NI Xiaoguang, HE Shun, GAO Li, et al. The application of narrow band imaging endoscopy in the early diagnosis of hypopharyngeal carcinoma[J]. Chin Arch Otolaryngol Head Neck Surg, 2009, 16(10):550-554.
[40] 倪晓光,程荣荣,高黎,等. 窄带成像内镜在鼻咽癌诊断中的价值[J]. 中国耳鼻咽喉头颈外科, 2012, 19(2):57-61. NI Xiaoguang, CHENG Rongrong, GAO Li, et al. Role of narrow-band imaging endoscopy in the diagnosis of nasopharyngeal carcinoma[J]. Chin Arch Otolaryngol Head Neck Surg, 2012, 19(2):57-61.
[41] Watanabe A, Tsujie H, Taniguchi M, et al. Laryngoscopic detection of pharyngeal carcinoma in situ with narrowband imaging[J]. Laryngoscope, 2006, 116(4):650-654.
[42] Shimizu Y, Yamamoto J, Kato M, et al. Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma[J]. Gastrointest Endosc, 2006, 64(2):255-259, 260-262.
[43] Savarino E, Corbo M, Dulbecco P, et al. Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia[J]. World J Gastroenterol, 2013, 19(17):2668-2675.
[44] Uedo N, Yao K, Ishihara R. Screening and treating intermediate lesions to prevent gastric cancer[J]. Gastroenterol Clin North Am, 2013, 42(2):317-335.
[45] Kikuchi O, Ezoe Y, Morita S, et al. Narrow-band imaging for the head and neck region and the upper gastrointestinal tract[J]. Jpn J Clin Oncol, 2013, 43(5):458-465.
[46] Adler A, Pohl H, Papanikolaou IS, et al. A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect?[J]. Gut, 2008, 57(1):59-64.

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