Narrow-band imaging: a useful tool for early recognition of oral lichen planus malignant transformation?
Narrow-band imaging: a useful tool for early recognition of oral lichen planus malignant transformation?
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DOI：
10.1684/ejd.2019.3638
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发表时间：
2019-09-01
影响因子：
2.5
通讯作者：
Parodi, Aurora
中科院分区：
文献类型：
--
作者：
Cozzani, Emanuele;Russo, Roberto;Parodi, Aurora
背景：口腔扁平苔藓(OLP)皮损的恶变率为1.37%。在慢性病患者中，恶性肿瘤的诊断依赖于临床怀疑指导下的组织病理学检查。窄带成像(NBI)是一种很有前途的内窥镜技术，它使用特定波长的滤光，可以突出与上呼吸道上皮亚临床肿瘤性改变相关的微血管异常。目的：本研究旨在分析NBI在口腔扁平苔藓临床变化出现前选择活检患者的价值，以便及早发现口腔扁平苔藓所致的口腔恶性肿瘤。材料和方法：进行前瞻性研究，纳入32名组织学诊断为口腔扁平苔藓且无口腔癌或其他口腔炎症性疾病的患者。可疑NBI病变的患者接受了活组织检查，而其他患者包括在随访中。结果：2例患者NBI评估阳性，组织学检查确诊为鳞癌。其他患者在随访期间均未出现恶性肿瘤的临床特征。结论：NBI评估可提高口腔扁平苔藓皮损亚临床癌变检测的准确性，并进一步鼓励临床医生在选定的病例中进行活检。
Background: Oral lichen planus (OLP) lesions have an overall malignant transformation rate of 1.37%. In patients with chronic disease, the diagnosis of malignancy relies on histopathological examination guided by clinical suspicion. Narrow-band imaging (NBI) is a promising endoscopic technique which, using a filtered light with specific wavelengths, can highlight microvascular abnormalities associated with subclinical neoplastic changes of the upper aerodigestive tract epithelium. Objectives: This study aimed to analyse the value of NBI in selecting patients for biopsy before the emergence of clinical changes, allowing early detection of oral malignancies arising from OLP. Materials and methods: A prospective study was conducted, enrolling 32 consecutive patients with a histological diagnosis of OLP with no previous diagnosis of oral cancer or other oral inflammatory diseases. Patients with suspicious NBI lesions underwent biopsies, while other patients were included in the follow-up. Results: Two patients were judged positive at NBI evaluation and squamous cell carcinoma was diagnosed after histological examination. None of the other patients developed clinical features of malignancies during follow-up. Conclusion: NBI evaluation may increase the accuracy of detection of subclinical neoplastic transformation in OLP lesions and further encourage clinicians to perform biopsies in selected cases.