Probe-based confocal laser endomicroscopy for diagnosis of nasopharyngeal carcinoma in vivo
Probe-based confocal laser endomicroscopy for diagnosis of nasopharyngeal carcinoma in vivo
复制标题
基于探针的共聚焦激光显微内镜诊断鼻咽癌体内
DOI：
10.1002/lary.27450
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发表时间：
2019-04-01
期刊：
影响因子：
2.6
通讯作者：
Li, Huawei
中科院分区：
文献类型：
--
作者：
Wu, Lingjie;Yu, Huiqian;Li, Huawei
目的/假设基于探针的激光共聚焦显微镜(PCLE)是一种能够在细胞水平上实时评估活体组织的组织学特征的新技术。本研究旨在评价pCLE在鼻咽癌诊断中的可行性。研究设计可行性研究。方法在静脉注射荧光素2.5ml后，活体获取病变的pCLE图像以及病变周围或对侧正常粘膜。在成像部位收集活检标本，然后由病理学家进行组织病理学诊断，以此作为金标准。通过敏感性、特异性、阴性预测值(NPV)和阳性预测值(PPV)将pCLE图像与可视化部位的组织病理学诊断进行比较。结果基于pCLE图像的诊断与基于组织学的金标准诊断有很好的相关性。PCLE诊断癌与非异型增生的灵敏度、特异度、PPV、NPV分别为93.8%(67.7%~99.7%)、90.5%(68.2%~98.3%)、88.2%(62.3%~97.9%)、95.0%(73.1%~99.7%)，四项指标分别为60.0%(17.0%~92.7%)。80.9%(57.4%~93.7%)、42.9%(11.8%~79.8%)和89.5%(65.5%~98.2%)。诊断鼻咽癌和异型增生的敏感性为93.8%(67.7%~99.7%)，特异性为40%(7.3%~83.0%)，PPV为83.3%(57.7%~95.6%)，NPV为66.7%(12.5%~98.2%)。
Objectives/HypothesisProbe-based confocal laser endomicroscopy (pCLE) is a novel technique allowing real-time evaluation of the histological features of tissues in vivo at the cellular level. This study aimed to evaluate the feasibility of using pCLE in the diagnosis of nasopharyngeal carcinoma (NPC).Study DesignFeasibility study.MethodsIn this study, the pCLE images of the lesions, as well as the surrounding or contralateral normal mucosa of the lesions, were acquired in vivo from each patient after intravenous injecting of 2.5mL fluorescein. Biopsy specimens were collected at the imaged sites followed by a histopathological diagnosis by the pathologists, which was used as the gold standard. The pCLE images were compared to histopathological diagnosis of visualized sites by using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).ResultsDiagnoses based on pCLE images correlated well with the gold standard diagnoses based on tissue histology. The overall sensitivity, specificity, PPV, and NPV for diagnosis of carcinoma versus nondysplasia were 93.8% (67.7%-99.7%), 90.5% (68.2%-98.3%), 88.2% (62.3%-97.9%), and 95.0% (73.1%-99.7%), respectively, and the four indices for pCLE diagnosis of dysplasia versus nondysplasia were 60.0% (17.0%-92.7%), 80.9% (57.4%-93.7%), 42.9% (11.8%-79.8%), and 89.5% (65.5%-98.2%), respectively. The overall sensitivity for diagnosis of carcinoma versus dysplasia was 93.8% (67.7%-99.7%), specificity was 40% (7.3%-83.0%), PPV was 83.3% (57.7%-95.6%), and the NPV was 66.7% (12.5%-98.2%).ConclusionsCLE is a suitable and valid method for otolaryngologists to diagnose of NPC in vivo.Level of EvidenceNA Laryngoscope, 129:897-902, 2019