Detection accuracy for epithelial dysplasia using an objective autofluorescence visualization method based on the luminance ratio.
Detection accuracy for epithelial dysplasia using an objective autofluorescence visualization method based on the luminance ratio.
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使用基于亮度比的客观自动荧光可视化方法的上皮发育不良的检测准确性。
DOI：
10.1038/ijos.2017.37
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发表时间：
2017-11-10
影响因子：
14.9
通讯作者：
Hamada Y
中科院分区：
文献类型：
--
作者：
Yamamoto N;Kawaguchi K;Fujihara H;Hasebe M;Kishi Y;Yasukawa M;Kumagai K;Hamada Y
自体荧光可视化方法（AVM）使用蓝色激发光来辅助诊断上皮异常增生。它检测上皮异型增生为黑色区域，这被称为荧光可视化损失（FVL）。在这项研究中，我们评估了使用客观AVM检测舌上皮发育不良的准确性，并评估其可能的临床效用。79例临床怀疑有白斑或鳞状细胞癌（SCC）的舌标本进行了分析。首先，使用视觉增强病变镜（VELscope）主观进行AVM，然后进行碘染色法。活检后，比较组织病理学结果和病变与健康组织之间的亮度比，并创建受试者工作特征曲线。确定客观AVM的截止值;当亮度比分别高于或低于截止值时，病变被认为是FVL阳性或阴性。79例标本的组织病理学诊断为SCC（n=30），白斑伴异型增生（n=34），白斑不伴异型增生（n=15）。亮度比的截止值为1.62，导致66个FVL阳性和13个FVL阴性标本。上皮异型增生阳性组的亮度比值显著高于上皮异型增生阴性组（P<0.0001）。客观AVM的组织病理学结果之间的一致性比两种方法高得多（kappa统计=0.656）。总之，客观自发荧光可视化具有作为诊断上皮异常增生的辅助方法的潜力。
The autofluorescence visualization method (AVM) uses blue excitation light to assist in the diagnosis of epithelial dysplasia. It detects epithelial dysplasia as a black area, which is known as fluorescence visualization loss (FVL). In this study, we evaluated the detection accuracy for epithelial dysplasia of the tongue using the objective AVM and assessed its possible clinical utility. Seventy-nine tongue specimens clinically suspected to have leukoplakia or squamous cell carcinoma (SCC) were analyzed. First, the AVM was subjectively performed using the Visually Enhanced Lesion scope (VELscope), and the iodine-staining method was then performed. After biopsy, the histopathological results and the luminance ratio between the lesion and healthy tissue were compared, and a receiver operating characteristic curve was created. The cutoff value for the objective AVM was determined; the lesion was considered FVL-positive or -negative when the luminance ratio was higher or lower than the cutoff value, respectively. The histopathological diagnoses among the 79 specimens were SCC (n=30), leukoplakia with dysplasia (n=34), and leukoplakia without dysplasia (n=15). The cutoff value of the luminance ratio was 1.62, resulting in 66 FVL-positive and 13 FVL-negative specimens. The luminance ratio was significantly higher in the epithelial dysplasia-positive than -negative group (P<0.000 1). The objective AVM showed much higher consistency between histopathological results than did the two methods (kappa statistic=0.656). In conclusion, objective autofluorescence visualization has a potential as an auxiliary method for diagnosis of epithelial dysplasia.
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