Diagnosis Of Early Carcinoma Of Larynx By Lodine Staining Under The Electronic Laryngoscope

Objective To investigate the feasibility and value of diagnosis of early carcinoma of larynx bylodine staining under under electronic laryngoscope.Methods In January2011to December2012, to see a doctor in the otorhinolaryngologyHead and Neck Surgery of Ningxia Medical University Hospital, Patients with hoarseness andincorporated into the standard of90people, according to different concentration of iodinestaining using iodine solution, were randomly divided into three groups, each group of30cases of patients. Experimental Ⅰ: namely0.5%Lugol solution group, this group of30casesof patients with simple electronic fiber laryngoscope,0.5%Lugol solution of iodine iodinestaining under the fiber laryngoscope, narrow-band imaging (NBI) three ways to check；Experimental Ⅱ:1.0%Lugol solution group, this group of30cases of patients with simpleelectronic fiber laryngoscope,1.0%Lugol solution of iodine iodine staining under the fiberlaryngoscope, NBI three methods; Experimental Ⅲ:1.5%Lugol solution group, this group of30cases of patients with simple electronic fiber laryngoscope,1.5%Lugol solution ofiodine iodine staining under the fiber laryngoscope, NBI three ways to check. Setting iodinestaining under the fiber laryngoscope to experiment method, electronic fiber laryngoscope andNBI are control methods. Specific as follows: the experimental group Ⅰ, experimentalgroup Ⅱ, experimental Ⅲ30patients in each group, check the laryngeal cavity with the fiberlaryngoscope to each patient, record found suspicious cancerous patients; In NBI moderespectively inspected each group of the patient’s throat, record found suspicious cancerouspatients; In each group under the fiber laryngoscope to iodine staining with certen iodinesolution concentration, observed the iodine staining results after laryngeal iodine staining30s, the same record suspicious cancerous patients. The above three groups of patients, each group30per capita for biopsy. Follow-up of patients with iodine staining24hours if there is ahearing is aggravating, choke to cough, dyspnea, cough, wheezing, the unwell symptom suchas a sore throat. First, according to the patients in an iodine staining under the fiberlaryngoscope to30seconds and follow-up of patients with laryngeal shaded iodine stainingoccur within24hours after not self-conscious symptom, concludes that electronic iodinestaining under the fiber laryngoscope is workable. Second to disease inspection results as thestandard, test results confirmed that the above three methods check found suspicious forcancer patients as a true positive cancerous patients, examination was found suspiciouslaryngeal cancer patients, the disease certificate is non cancer patients which is really negativepatients, thus concludes that each group of each method respectively number of true positiveand negative patients. Each group of patients with laryngeal suspicious cancerous patientsfound in some way to check the number minus the number of true positive patients, themethod can get a false positive patients. With30cases in each group after challenged diseaseis the number of cancer patients minus the number of true negative patients, the method isboth false negative patients. Statistical comparison respectively in each group in a separateuse electronic fiber laryngoscope, NBI, iodine staining under the fiber laryngoscope to eachmethod in three methods found that the number of false positive and false negative patients,so as to calculate each group of each method in three methods for early laryngeal cancerdiagnostic sensitivity and specificity. Iodine staining under the fiber laryngoscope for earlylaryngeal cancer diagnosis sensitivity respectively and separately use the fiber laryngoscope,NBI two methods, in statistical inference, using2test, the standard used (P <0.05). Todiscuss the value of the iodine staining under electronic laryngoscope in the diagnosis of earlylaryngeal cancer.Results(1) Three groups of patients in the trials, a total of90people, after electronic iodine stainingunder the fiber laryngoscope to all said can tolerate.0.5%,1.0%Lugol iodine liquid with laryngeal cavity after dyeing were no throat discomfort of all patients complained of.1.5%Lugol solution group of30patients, including3of pharynx ministry is unwell, noneappear to hearing is aggravating, choke to cough, your breath, severe cough and difficultybreathing. So the electronic under the fiber laryngoscope iodine staining in the throat ofthe solution is feasible.(2)0.5%Lugol solution group,30persons，pathology confirmed for cancer patients, a total of21people.Separate use electronic fiber laryngoscope check found suspicious cancerouspatients, the disease testing actually is really positive for cancer patients has13people.Separate to use electronic fiber laryngoscope inspection found no laryngeal patients withsuspicious cancerous lesions, challenged by the disease is not cancer patients also namelytrue negative6people. False-negative patients a total of3people, a false positive inpatients with a total of7people, sensitivity61.90%, specificity of66.67%; NBI, truepositive patients19people,8people true negative, false negative of patients with a totalof2people, a false positive patients with1person, sensitivity90.47%, specificity of88.87%;0.5%Lugol liquid iodine staining under the fiber laryngoscope, true positivepatients with14people, true negative6people, false-negative patients a total of3people,a false positive in patients with a total of7people, sensitivity66.67%, specificity of66.67%. This experiment study of30people within24hours after iodine staining were nohearing is aggravating, choke to cough, no difficulty breathing, a sore throat discomfortand other symptoms.(3)1.0%Lugol solution grope30people, pathology confirmed for cancer patients, a total of20people.Separately use the fibre laryngoscope check found suspicious cancerous patients,the disease testing as well as cancer patients or true positive patients with13people.Separate use electronic fiber laryngoscope inspection found no laryngeal patients withsuspicious cancerous lesions, challenged by the disease is not cancer patients also namelytrue negative patients with7people. False-negative patients a total of7people, a falsepositive in patients with a total of3people, sensitivity65.00%, specificity of70.00%;NBI, true positive patients19people,9people true negative, false negative of patientswith a total of1people, a false positive patients with1person, sensitivity90.47%, specificity of90.00%;1.0%Lugol liquid iodine staining under the fiber laryngoscope, truepositive patients17people, true negative8people, false-negative patients a total of3people, a false positive in patients with a total of2people, sensitivity85.00%, specificityof80.00%. This experiment study of30people within24hours after iodine staining wereno hearing is aggravating, choke to cough, no difficulty breathing, a sore throat discomfortand other symptoms.(4)1.5%Lugol solution group A total of30people, pathology confirmed for cancer patients, atotal of21people.Separately use the fiber laryngoscope check found suspicious cancerouspatients, the disease testing as well as cancer patients or true positive patients with13people. Separate use electronic fiber laryngoscope inspection found no laryngeal patientswith suspicious cancerous lesions, challenged by the disease is not cancer patients alsonamely true negative patients with6people. False-negative patients a total of8people, afalse positive in patients with a total of3people, sensitivity61.90%, specificity of66.67%;NBI, true positive patients with20people,8people true negative, false negative ofpatients with1person, false positive patients with1person, sensitivity95.23%, specificityof88.87%;1.0%Lugol liquid iodine staining under the fiber laryngoscope, true positivepatients19people,8people true negative, false negative of patients with a total of2people, a false positive patients with1person, sensitivity90.47%, specificity of88.89%.There are3people in this group have mild symptoms in throat within24hours afteriodine staining,among them2cases,the symptoms disappear after24hours,1case wasgiven symptoms disappear after atomized inhalation,30per capita has no obvious sorethroat, choking cough, dyspnea, wheeze, hearing is aggravated serious complications.(5) data by statistical analysis, the inspection, the inspection standard (P <0.05). Viastatistical calculations that the1.0%and below the concentration of iodine staining fluid,in diagnosis of the early laryngeal cancer, its diagnostic sensitivity is higher than ordinaryelectronic fiber nasopharyngoscope, but with the ordinary electronic fibernasopharyngoscope statistical analysis, the2values are less than2(0.05,1), P> P(0.05), no statistical significance, it howed that no statistical difference between them in diagnosis of early laryngeal cancer;1.5%Lugol solution group,through statisticalcalculation, a value ofχ~2=4.725, andχ~2(0.05,1)=3.84, P <P (0.05), they arestatistically significant, there is a significant difference in them, we can think of iodinestaining under electronic fiber nasopharyngoscope is higher than common electronic fibernasopharyngoscope in diagnosis rate of diagnosis of early laryngeal cancer, so the iodinestaining under endoscopy in early laryngeal cancer diagnosis is feasible, and valuable.Conclusion1. Throat staining with1.5%and below this concentration of iodine solutionunder the nasopharyngoscope is safe and feasible.2. With the increase of concentration ofiodine solution, gradually increase the susceptibility of the diagnosis of early laryngeal cancer.3. In diagnosis of early laryngeal cancer, the1.5%Lugol solution of iodine stainingunder the electronic fiber nasopharyngoscope is superior than ordinary electronic fibernasopharyngoscope.