Diagnostic Accuracy of High-Grade Intraepithelial Papillary Capillary Loops by Narrow Band Imaging for Early Detection of Oral Malignancy: A Cross-Sectional Clinicopathological Imaging Study.
Diagnostic Accuracy of High-Grade Intraepithelial Papillary Capillary Loops by Narrow Band Imaging for Early Detection of Oral Malignancy: A Cross-Sectional Clinicopathological Imaging Study.
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本研究旨在阐明常规目视检查（CVI）、内镜下白色光成像（WLI）和窄带成像（NBI）的优缺点，并检查上皮内乳头状毛细血管袢（IPCL）检测口腔鳞状细胞癌（OSCC）的诊断准确性。所有OSCC病例均表现为高级别（III-IV型）IPCL。不均匀病变伴高级别IPCL强烈提示恶性。我们的研究结果表明，WLI和NBI是使用IPCL检测癌前病变和癌性病变的有力工具。然而，NBI受粘膜厚度的影响;因此，图像解释很重要。本研究旨在阐明常规目视检查（CVI）、内镜下白色光成像（WLI）和窄带成像（NBI）的优缺点，并检查上皮内乳头状毛细血管袢（IPCL）检测口腔鳞状细胞癌（OSCC）的诊断准确性。这项横断面研究包括60名口腔粘膜疾病的参与者，怀疑有口腔潜在恶性疾病（OPMD）或OSCC。患者接受了CVI、WLI、NBI和切口活检。对图像进行评价，以评估病变大小、颜色、纹理和IPCL。口腔扁平苔藓（OLP）和口腔白斑病变观察到的NBI的面积大于WLI; 75.0%与低度（0-II型）IPCL相关。各种类型的口腔白斑被认为是，但是，所有的口腔鳞状细胞癌病例显示高级别（III-IV型）IPCL。高级别IPCL对口腔鳞癌诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为100%、80.9%、59.1%、100%和85.0%。不均匀病变伴高级别IPCL强烈提示恶性。总体而言，我们的研究结果表明，WLI和NBI是使用IPCL检测癌前病变和癌性病变的有力工具。然而，NBI受粘膜厚度的影响;因此，图像解释对于准确诊断很重要。
This study aimed to clarify the advantages and disadvantages of conventional visual inspection (CVI), endoscopic white light imaging (WLI), and narrow-band imaging (NBI) and to examine the diagnostic accuracy of intraepithelial papillary capillary loops (IPCL) for the detection of oral squamous cell carcinoma (OSCC). All OSCC cases showed high-grade (Type III–IV) IPCL. A non-homogeneous lesion with high-grade IPCL strongly suggested malignancy. Our results indicate that WLI and NBI are powerful tools for detecting precancerous and cancerous lesions using IPCL. However, NBI is influenced by mucosal thickness; therefore, image interpretation is important. This study aimed to clarify the advantages and disadvantages of conventional visual inspection (CVI), endoscopic white light imaging (WLI), and narrow-band imaging (NBI) and to examine the diagnostic accuracy of intraepithelial papillary capillary loops (IPCL) for the detection of oral squamous cell carcinoma (OSCC). This cross-sectional study included 60 participants with oral mucosal diseases suspected of having oral potentially malignant disorders (OPMDs) or OSCC. The patients underwent CVI, WLI, NBI, and incisional biopsy. Images were evaluated to assess the lesion size, color, texture, and IPCL. Oral lichen planus (OLP) and oral leukoplakia lesions were observed in larger areas with NBI than with WLI; 75.0% were associated with low-grade (Type 0–II) IPCL. Various types of oral leukoplakia were seen; however, all OSCC cases showed high-grade (Type III–IV) IPCL. The diagnostic accuracy of high-grade IPCL for OSCC showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 80.9%, 59.1%, 100%, and 85.0%, respectively. A non-homogeneous lesion with high-grade IPCL strongly suggested malignancy. Overall, our results indicate that WLI and NBI are powerful tools for detecting precancerous and cancerous lesions using IPCL. However, NBI is influenced by mucosal thickness; therefore, image interpretation is important for accurate diagnosis.
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