A pilot study of autofluorescent endoscopy for the in vivo detection of laryngeal cancer
A pilot study of autofluorescent endoscopy for the in vivo detection of laryngeal cancer
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DOI：
10.1097/00005537-200003000-00007
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发表时间：
2000-03-01
期刊：
影响因子：
2.6
通讯作者：
Stoll, W
中科院分区：
文献类型：
--
作者：
Delank, W;Khanavkar, B;Stoll, W
目的：探讨自动荧光内窥镜在喉癌诊断中的优势。研究设计：这是一项前瞻性的多中心临床研究。我们研究了使用肺成像荧光内窥镜(LIFE)-肺系统(Xillix，奥林巴斯)的自动荧光内窥镜是否能够识别早期喉癌，特别是与传统的白光内窥镜和显微喉镜检查相比。喉部良性病变以及微小浸润性和浸润性鳞状细胞癌由于逻辑原因而被调查，由于这项研究的试点性质，患者数量有限。方法：对16例患者的24个喉部良、恶性病变进行自动荧光内窥镜、白光内窥镜和显微喉镜检查。根据肿瘤的光学表现，根据不同的检查方法，将病变分为恶性或非恶性。目测结果被记录在案，并得到组织学证实。结果：自动荧光内窥镜对喉癌的诊断灵敏度达90%以上，高于白光鼻内窥镜和显微喉镜。然而，就喉癌而言，自动荧光内窥镜检查的特异性很低。许多假阳性结果是由于炎症、血管增多和水肿所致。结论：自动荧光内窥镜检查只有在有经验的耳鼻喉科专家的手中才有优势。虽然它不能取代白光内窥镜和对个别疾病的临床症状的关键评估的组合，但它可以对它们进行有益的补充。自动荧光内窥镜检查有助于确定是否应向患者紧急推荐在全身麻醉下进行显微喉镜检查。如果喉镜检查结合多次活检标本的获取，仍是鉴别恶性病变的最佳方法。这项先导研究的结果在更大范围的患者中得到证实是可取的。
Objectives: To determine the advantage of autofluorescent endoscopy for the identification of laryngeal cancer. Study Design: This is a prospective, multicenter clinical study. We investigated whether autofluorescent endoscopy using the Lung Imaging Fluorescent Endoscopy (LIFE)-Lung System (Xillix, Olympus) is capable of identifying early cancer of the larynx, especially in comparison with conventional white-light endoscopy and microscopic laryngoscopy. Benign lesions as well as microinvasive and invasive squamous cell carcinoma of the larynx were investigated For logistic reasons and because of the pilot character of this study, the number of patients was limited. Methods: Sixteen patients having 24 laryngeal lesions of both benign or malignant character were subsequently examined by autofluorescent endoscopy, white-light endoscopy, and microscopic laryngoscopy. Based on optical appearance, and for each method separately, the lesions were classified as malignant or not. The visual results were documented and histologically verified. Results: The sensitivity of autofluorescent endoscopy for laryngeal cancer detection was more than 90% and therefore higher than that of white-light endoscopy and microscopic laryngoscopy. However, as far as laryngeal cancer is concerned, the specificity of autofluorescent endoscopy was very low. Many of the false-positive results were due to inflammation, hypervascularization, and edema Conclusion: Autofluorescent endoscopy is advantageous only in the hands of an experienced ENT specialist. Although it does not replace the combination of white-light endoscopy and a critical evaluation of the clinical symptoms of the individual disease, it can profitably complement them. Autofluorescent endoscopy can help in determining whether microscopic laryngoscopy performed with general anesthesia should be recommended urgently to the patient. Microscopic laryngoscopy remains the best method for the identification of malignant lesions, if it is combined with obtaining taking multiple biopsy specimens. Confirmation of the results of this pilot study with a larger series of patients is desirable.