Enhanced contact endoscopy for the assessment of the neoangiogenetic changes in precancerous and cancerous lesions of the oral cavity and oropharynx
Enhanced contact endoscopy for the assessment of the neoangiogenetic changes in precancerous and cancerous lesions of the oral cavity and oropharynx
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DOI：
10.1007/s00405-015-3698-2
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发表时间：
2016-07-01
影响因子：
2.6
通讯作者：
Puxeddu, Roberto
中科院分区：
文献类型：
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作者：
Carta, Filippo;Sionis, Sara;Puxeddu, Roberto
上呼吸消化道的不典型增生和鳞状细胞癌表现出明显的新生血管形成，表现为上皮下和上皮微血管不规则，可以通过图像增强内窥镜（如窄带成像和Storz专业图像增强系统）检测到。在本研究中，最先进的内窥镜增强系统与接触式内窥镜（增强型接触式内窥镜）相结合。这一新颖的方法提高了对42例口腔和口咽部白斑、红斑和白斑-红斑患者绒毛膜新生血管发生变化的识别和理解。在增强接触式内窥镜检查中观察到的5种明显的血管模式中描述了生理和病理粘膜，从正常到鳞状细胞癌，经过炎症、增生和异型增生。然后将每种血管模式与组织学进行比较，结果表明增强型接触式内窥镜观察到的微血管结构变化几乎是恒定的。在健康粘膜和炎症与病理性增生、异型增生和癌之间鉴别的敏感性、特异性、阳性预测值和阴性预测值分别为96.6%、93.3%、98.2%、87.5%和95.9%。鉴别非恶性病变与鳞状细胞癌的敏感性和特异性均为100%。我们的初步经验表明，如果与接触式内窥镜联合使用，图像增强内窥镜在口腔和口咽癌前病变和鳞状细胞癌诊断中的准确性可以提高。
Dysplasia and squamous cell carcinoma of the upper aerodigestive tract show significant neoangiogenesis appearing as subepithelial and epithelial microvascular irregularities that can be detected by Image-Enhanced Endoscopy such as Narrow Band Imaging and Storz Professional Image Enhancement System. In the present study, the most advanced endoscopic enhancement systems were coupled with Contact Endoscopy (Enhanced Contact Endoscopy). This original method improved the identification and the understanding of the neoangiogenetic changes of the chorion in 42 patients with leukoplakia, erythroplakia, and leuko-erythroplakia of the oral cavity and oropharynx. The physiologic and pathologic mucosa was described in five obvious vascular patterns observed at Enhanced Contact Endoscopy ranging from normal to squamous cell carcinoma, passing through inflammation, hyperplasia, and dysplasia. Each vascular pattern was then compared to histology, showing that the microvascular architectural changes seen with Enhanced Contact Endoscopy are almost constant. Sensitivity, specificity, positive predictive value, and negative predictive value in the differentiation between healthy mucosa and inflammation versus pathologic hyperplasia, dysplasia, and carcinoma were, respectively, 96.6, 93.3, 98.2, 87.5, and 95.9 %. Sensitivity and specificity were 100 % in differentiation between non-malignant lesions versus squamous cell carcinoma. Our preliminary experience shows that accuracy of Image-Enhanced Endoscopy in the diagnosis of precancerous lesions and squamous cell carcinoma of the oral cavity and oropharynx can be increased if associated to Contact Endoscopy.