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Ren Y, Fang G, Wang K, Yan B, Wang C. The diagnostic value of image-enhanced endoscopy system in sinonasal inverted papilloma. Eur Arch Otorhinolaryngol 2024; 281:4221-4230. [PMID: 38713292 DOI: 10.1007/s00405-024-08707-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE This study aimed to evaluate the diagnostic value of image-enhanced endoscopy (IEE) in detecting sinonasal inverted papilloma (SNIP). METHODS Overall, 86 patients with unilateral nasal papillary or lobulated neoplasms were included between July 2018 and June 2019. All patients underwent IEE examinations, and the diagnosis of all neoplasms was confirmed through postoperative pathology. Logistic regression analysis was conducted to screen for independent predictors of various types of vascular patterns of SNIP. Furthermore, a prognostic nomogram was constructed using the independent predictors screened by logistic regression analysis to evaluate its usefulness in distinguishing SNIP from nasal polyp (NP) and papillary mucosa folds (PMF). RESULTS In total, 86 consecutive cases were observed, including 37 with SNIP, 40 with NP, and 9 with PMF. Logistic regression analysis showed that spot, corkscrew, and multilayered vascular patterns were independent predictors of SNIP diagnosis. Furthermore, a nomogram comprising the three independent risk factors was constructed with scores of 5, 2, and 3. The area under the receiver operating characteristic curve for predicting SNIP was 0.954, 0.66, 0.71, and 0.76 for the nomogram model, spot vascular pattern, corkscrew vascular pattern, and multilayered vascular pattern, respectively. CONCLUSION The nomogram model based on spot, corkscrew, and multilayered vascular patterns in SNIP observed using IEE can be a useful diagnostic tool for predicting and distinguishing between NP and PMF.
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Affiliation(s)
- Yimin Ren
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
- Beijing Laboratory of Allergic Diseases, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal Diseases, Capital Medical University, Beijing, 100005, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, 100005, China
| | - Gaoli Fang
- Department of Otolaryngology Head and Neck Surgery, Beijing DiTan Hospital, Capital Medical University, Beijing, China
| | - Kuiji Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, 100005, China
| | - Bing Yan
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
- Beijing Laboratory of Allergic Diseases, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal Diseases, Capital Medical University, Beijing, 100005, China.
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, 100005, China.
| | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
- Beijing Laboratory of Allergic Diseases, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal Diseases, Capital Medical University, Beijing, 100005, China.
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, 100005, China.
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Kraus F, Gehrke S, Ehrmann-Müller D, Hofer F, Shehata-Dieler W, Hagen R, Scherzad A. Comparison of three different image enhancement systems for detection of laryngeal lesions. J Laryngol Otol 2024; 138:105-111. [PMID: 37211357 PMCID: PMC10772018 DOI: 10.1017/s0022215123000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/08/2023] [Accepted: 04/25/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Image enhancement systems are important diagnostic tools in the detection of laryngeal pathologies. This study aimed to compare three different image enhancement systems: professional image enhancement technology, Image1 S and narrow-band imaging. METHOD Using the three systems, 100 patients with laryngeal lesions were investigated using a flexible and a 30° rigid endoscope. The lesions were diagnosed by three experts and classified using the Ni classification. The findings were compared. RESULTS Lesions classified as 'benign' were histopathologically confirmed in 50 per cent of patients, malignant lesions were confirmed in 41 per cent and recurrent respiratory papillomatosis were confirmed in 9 per cent. There was no significant difference between the experts' assessments of each image enhancement system. CONCLUSION The three systems give comparable results in the detection of laryngeal lesions. With two additional systems, more users can perform image-enhanced endoscopy, resulting in a broadly available tool that can help to improve oncological assessment.
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Affiliation(s)
- Fabian Kraus
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Sven Gehrke
- School of Economics and Business Administration, University of Jena, Jena, Germany
| | - Desiree Ehrmann-Müller
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Frank Hofer
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Bundeswehr Hospital Ulm, Ulm, Germany
| | - Wafaa Shehata-Dieler
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
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Ragonesi T, Niederhauser L, Fernandez IJ, Molinari G, Caversaccio M, Presutti L, Anschuetz L. Digital image enhancement may improve sensitivity of cholesteatoma detection during endoscopic ear surgery. Clin Otolaryngol 2023. [PMID: 36939045 DOI: 10.1111/coa.14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVES This study investigates the possible benefits and limitations of the digital image enhancement systems provided by Storz Professional Image Enhancement System (SPIES) during endoscopic ear surgery (EES) for cholesteatoma. An increased detection of cholesteatoma residuals during the final steps of endoscopic surgery using DIE technology was hypothesized. DESIGN Cross-sectional study. SETTING Tertiary referral hospital. METHODS A total of 10 questionnaires of 18 intraoperative pictures with equal numbers of cholesteatoma and non-cholesteatoma images, each presented in three different image-enhancing modalities (Clara, Spectra A, Spectra B), were generated. Fifty-one experienced ear surgeons participated to the survey and were randomly assigned to a questionnaire and completed it at two time points. The experts were asked to rate for each picture whether cholesteatoma was present or not. The answers were compared with the histopathological reports. RESULTS Clara showed the highest accuracy in cholesteatoma detection, followed by Spectra A and lastly Spectra B. In contrast, Spectra B showed the highest sensitivity and Clara the highest specificity, while Spectra A was placed in the middle for both values. Using the Spectra B modality, most responses agreed across the two time points. Ear surgeons assessed the usefulness, as well as preference among image modalities for cholesteatoma surgery, in the following order: Clara, Spectra B, Spectra A. CONCLUSION Digital enhancement technologies are applicable to EES. After complete cholesteatoma removal, Spectra B showed the highest sensitivity in the detection of cholesteatoma residuals as compared with Clara and Spectra A. Thus, Spectra B may be recommended to avoid missing any cholesteatoma residuals during EES.
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Affiliation(s)
- Talisa Ragonesi
- Department of Otolaryngology - Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | | | - Ignacio Javier Fernandez
- Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giulia Molinari
- Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Caversaccio
- Department of Otolaryngology - Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Livio Presutti
- Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Lukas Anschuetz
- Department of Otolaryngology - Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland
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Surgical Treatment for Advanced Oropharyngeal Cancer: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020304. [PMID: 36837506 PMCID: PMC9961866 DOI: 10.3390/medicina59020304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/30/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
Background and Objectives: to describe current scientific knowledge regarding the treatment options in advanced oropharyngeal cancer. The standard care for advanced oropharyngeal cancer (OPSCC) has been chemoradiotherapy, although surgical approaches followed by adjuvant treatment have been proposed. The best therapy for each patient should be decided by an interdisciplinary tumour-board. Different strategies should be considered for the specific patient's treatment: surgery, chemotherapy and radiation therapy or combinations of them. The treatment choice is influenced by tumour variability and prognostic factors, but it also depends on cancer extension, extranodal extension, nervous invasion, human papilloma virus (HPV) presence, making the decisional algorithm not always clear. HPV-related OPSCC is strongly associated with a favourable overall survival (OS) and disease-free survival rate (DSS); by contrast, HPV-negative OPSCC often flags a worse prognosis. Consequently, the American Joint Committee on Cancer (AJCC) differentiates OPSCC treatment and prognosis based on HPV status. Methods: we carried out a review of current scientific literature to analyze the different indications and limitations of surgical treatment options in OPSCC stage III and IV. Conclusion: robotic surgery or open approaches with reconstructive flaps can be considered in advanced stages, resulting in the de-intensification of subsequent systemic therapy and fewer related side effects. Furthermore, in the event of the primary failure of systemic therapy or disease recurrence, the surgical approach constitutes an additional therapeutic option which lengthens patient survival functions.
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Azam MA, Sampieri C, Ioppi A, Benzi P, Giordano GG, De Vecchi M, Campagnari V, Li S, Guastini L, Paderno A, Moccia S, Piazza C, Mattos LS, Peretti G. Videomics of the Upper Aero-Digestive Tract Cancer: Deep Learning Applied to White Light and Narrow Band Imaging for Automatic Segmentation of Endoscopic Images. Front Oncol 2022; 12:900451. [PMID: 35719939 PMCID: PMC9198427 DOI: 10.3389/fonc.2022.900451] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/26/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Narrow Band Imaging (NBI) is an endoscopic visualization technique useful for upper aero-digestive tract (UADT) cancer detection and margins evaluation. However, NBI analysis is strongly operator-dependent and requires high expertise, thus limiting its wider implementation. Recently, artificial intelligence (AI) has demonstrated potential for applications in UADT videoendoscopy. Among AI methods, deep learning algorithms, and especially convolutional neural networks (CNNs), are particularly suitable for delineating cancers on videoendoscopy. This study is aimed to develop a CNN for automatic semantic segmentation of UADT cancer on endoscopic images. Materials and Methods A dataset of white light and NBI videoframes of laryngeal squamous cell carcinoma (LSCC) was collected and manually annotated. A novel DL segmentation model (SegMENT) was designed. SegMENT relies on DeepLabV3+ CNN architecture, modified using Xception as a backbone and incorporating ensemble features from other CNNs. The performance of SegMENT was compared to state-of-the-art CNNs (UNet, ResUNet, and DeepLabv3). SegMENT was then validated on two external datasets of NBI images of oropharyngeal (OPSCC) and oral cavity SCC (OSCC) obtained from a previously published study. The impact of in-domain transfer learning through an ensemble technique was evaluated on the external datasets. Results 219 LSCC patients were retrospectively included in the study. A total of 683 videoframes composed the LSCC dataset, while the external validation cohorts of OPSCC and OCSCC contained 116 and 102 images. On the LSCC dataset, SegMENT outperformed the other DL models, obtaining the following median values: 0.68 intersection over union (IoU), 0.81 dice similarity coefficient (DSC), 0.95 recall, 0.78 precision, 0.97 accuracy. For the OCSCC and OPSCC datasets, results were superior compared to previously published data: the median performance metrics were, respectively, improved as follows: DSC=10.3% and 11.9%, recall=15.0% and 5.1%, precision=17.0% and 14.7%, accuracy=4.1% and 10.3%. Conclusion SegMENT achieved promising performances, showing that automatic tumor segmentation in endoscopic images is feasible even within the highly heterogeneous and complex UADT environment. SegMENT outperformed the previously published results on the external validation cohorts. The model demonstrated potential for improved detection of early tumors, more precise biopsies, and better selection of resection margins.
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Affiliation(s)
- Muhammad Adeel Azam
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Claudio Sampieri
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alessandro Ioppi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Pietro Benzi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Giorgio Gregory Giordano
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Marta De Vecchi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Valentina Campagnari
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Shunlei Li
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Luca Guastini
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Sara Moccia
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Leonardo S Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Giorgio Peretti
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
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Englhard AS, Ledderose C, Volgger V, Ledderose GJ. Evaluation of an image enhancement system for the assessment of nasal and paranasal sinus diseases. Am J Otolaryngol 2022; 43:103323. [PMID: 34933164 DOI: 10.1016/j.amjoto.2021.103323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/24/2021] [Accepted: 12/08/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Dysplasia and cancer of the upper aerodigestive tract are characterized by significant neoangiogenesis. This can be recognized by optical methods like the Storz Professional Image Enhancement System (SPIES). Up to now, there are no reports of using this novel technique for examining nasal diseases. The objective of this study was to evaluate the use of SPIES during sinus surgery to help differentiate various nasal pathologies and determine their extension. METHODS Patients (n = 27) with different pathologies in the region of the paranasal sinuses were operated via functional endoscopic surgery using a 2D-HD-camera with white light and SPIES. In addition, 10 healthy individuals were examined. The system was evaluated using two different questionnaires. RESULTS The handling and operation of SPIES was intuitive and easy. Use of SPIES did not prolong the procedure. There was no disturbing image distortion. SPIES seemed to improve the visualization, differentiation and evaluation of vascularization of paranasal pathologies and allowed for precise and accurate surgery. Compared to examination with the 2D-HD-camera and white light alone, SPIES appeared to facilitate the identification of mucosal pathologies. CONCLUSION SPIES could be a promising adjunct tool to evaluate nasal pathologies intraoperatively. Especially in the case of vascularized tumors the enhanced image endoscopy seemed to be clearly superior to standard white light alone. In our study, the system facilitated the assessment of tumor extension and vascularization as well as the differentiation of healthy mucosa. Future randomized studies will be necessary to prove the potential of integrating this novel technique into the clinical routine for the differentiation of nasal pathologies and the improvement of resection margins during nasal tumor surgery.
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Jackson C, Kong DK, Gersey ZC, Wang EW, Zenonos G, Snyderman CH, Gardner PA. Contact endoscopy as a novel technique for intra-operative identification of normal pituitary gland and adenoma. NEUROSURGICAL FOCUS: VIDEO 2022; 6:V17. [PMID: 36284593 PMCID: PMC9557328 DOI: 10.3171/2021.10.focvid21199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/22/2021] [Indexed: 11/06/2022]
Abstract
Intraoperative distinction of pituitary adenoma from normal gland is critical in maximizing tumor resection without compromising pituitary function. Contact endoscopy provides a noninvasive technique that allows for real-time in vivo visualization of differences in tissue vascularity. Two illustrative cases of endoscopic endonasal approaches (EEAs) for resection of pituitary adenoma illustrate the use of contact endoscopy in identifying tumor from gland and differentiating a thin section of normal gland draped over the underlying tumor, thereby allowing for safe extracapsular tumor resection. Contact endoscopy may be used as an adjunct for intraoperative, in vivo differentiation of pituitary gland and adenoma.
The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21199
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Affiliation(s)
| | - Derek Kai Kong
- Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Eric W. Wang
- Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Carl H. Snyderman
- Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Moffa A, Giorgi L, Costantino A, De Benedetto L, Cassano M, Spriano G, Mercante G, De Virgilio A, Casale M. Accuracy of autofluorescence and chemiluminescence in the diagnosis of oral Dysplasia and Carcinoma: A systematic review and Meta-analysis. Oral Oncol 2021; 121:105482. [PMID: 34399191 DOI: 10.1016/j.oraloncology.2021.105482] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To define the accuracy of autofluorescence-based (AF) and chemiluminescence-based (CL) systems in the diagnosis of oral dysplastic and malignant lesions in addition to the Conventional Oral Examination (COE). MATERIALS AND METHODS The study was performed according to the PRISMA-DTA guidelines. RESULTS A total of 2631 oral cavity lesions (AF, n = 2076; CL, n = 555) from 26 studies (AF = 17; CL = 9) was used for calculation of diagnostic accuracy parameters. The overall pooled sensitivity and specificity of the AF were 81.3% (95% CI: 74.3% - 87.5%) and 52.1% (95% CI: 36.9% - 67.1%), respectively. Cumulative diagnostic odds ratio (DOR) was 5.44 (95% CI: 2.29 - 10.56) with a significant heterogeneity between studies (I2 = 80.7%, 95% CI: 70.0% - 86.7%; p < .05). The overall pooled sensitivity and specificity for the CL were 84.9% (95% CI: 66.7% - 96.7%) and 51.8% (95% CI: 37.3% - 65.9%), respectively. The overall pooled DOR was 8.59 (95% CI: 2.11 - 22.38) with a significant heterogeneity between studies (I2 = 65.4%, 95% CI: 29.6% - 83.0%; p < .05). CONCLUSIONS AF and CL present a high sensitivity in the diagnosis of dysplastic and malignant oral cavity lesions, demonstrating that diagnostic biopsies may be avoided in case of a negative test result. Both tests have a low specificity, and the reduction of the false positive rate compared to the COE alone remains poor.
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Affiliation(s)
- Antonio Moffa
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy; Unit of Otolaryngology, University of Foggia, Foggia, Italy
| | - Lucrezia Giorgi
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy.
| | - Luigi De Benedetto
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | | | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
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Cheng Y, Fang Q, Chen Y, Zang G, Yao J. High Expression of Tumor Abnormal Protein Preoperatively Predicts Poor Prognosis of Patients With Esophageal Squamous Cell Carcinoma. Front Surg 2021; 8:609719. [PMID: 33718426 PMCID: PMC7945947 DOI: 10.3389/fsurg.2021.609719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Esophageal squamous cell carcinoma (ESCC) acts as a fatal malignant tumor among human beings and is marked by late-stage diagnosis, frequent recurrence, metastasis, and therapy resistance. Tumor abnormal protein (TAP) remarkably affects cancer development and progression of human cancers. TAP has been shown to be a biomarker for gastric and lung cancer progression. Nevertheless, the clinical value exhibited by TAP for ESCC has not been well-explained in the current literature. Methods: The present study included 183 ESCC cases who received surgical resection and 183 cases who had normal physical checkup from March 2013 to January 2015 at the People's Hospital of Chizhou, and used the TAP detection agent for evaluating the TAP relative level. Results: As found, ESCC patients presented an obviously higher TAP expression relative to cases who had normal physical checkup. Moreover, TAP expression was significantly downregulated after surgery. Furthermore, the TAP expression was correlated with gender, smoking, pathologic differentiation, and pN stage, but not with age, tumor location, surgical type, pT stage, and vascular invasion. High expression of TAP was significantly correlated with poorer overall survival (OS) rate in ESCC patients. TAP was an independent prognostic predictor in ESCC patients, based on the multivariate survival analysis. Conclusion: The study reveals how TAP upregulation promotes ESCC malignant progression, and concludes that TAP acts as the therapeutic target and potential biomarker specific to ESCC.
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Affiliation(s)
- Yuanjun Cheng
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, China
| | - Qianru Fang
- Department of Obstetrics, People's Hospital of Chizhou, Chizhou, China
| | - Yongbing Chen
- Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Guohui Zang
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, China
| | - Jie Yao
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, China
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10
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Carta F, Quartu D, Mariani C, Tatti M, Marrosu V, Gioia E, Gerosa C, Zanda JSA, Chuchueva N, Figus A, Puxeddu R. Compartmental Surgery With Microvascular Free Flap Reconstruction in Patients With T1-T4 Squamous Cell Carcinoma of the Tongue: Analysis of Risk Factors, and Prognostic Value of the 8th Edition AJCC TNM Staging System. Front Oncol 2020; 10:984. [PMID: 32760667 PMCID: PMC7372302 DOI: 10.3389/fonc.2020.00984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Compartmental surgery and primary reconstruction with microvascular free flaps represent the gold-standard in the treatment of oral tongue squamous cell carcinoma (OTSCC). However, there are still unclear clinical features that negatively affect the outcomes. This retrospective study included 80 consecutive patients with OTSCC who underwent compartmental surgery and primary reconstruction by free flap. The oncologic outcomes, the reliability of the 8th edition American Joint Committee on Cancer (AJCC) staging system and the prognostic factors were evaluated. Fifty-nine males and 21 females (mean age 57.8 years, range 27-81 years) were treated between November 2010 and March 2018 (one patient had two metachronous primaries). Seventy-one patients (88.75%, 52 males, 19 females, mean age of 57.9 years, range of 27-81 years) had no clinical history of previous head and neck radiotherapy and were considered as naive. Histology showed radical surgery on 80/81 lesions (98.8%), with excision margins >0.5 cm, while in 1 case (1.2%), a close posterior margin was found. According to the 8th AJCC classification, 37 patients (45.7%) were upstaged shifting from the clinical to the pathological stage, and 39 (48.1%) showed an upstaging while shifting from the 7th to the 8th AJCC staging system (no tumors were downstaged). Nodal involvement was confirmed in 33 patients (40.7%). Perineural and lymphovascular invasion were present in 9 (11.1%) and 11 (13.6%) cases, respectively. Twenty-two patients (27.1%) underwent adjuvant therapy. The 5-years disease-specific, overall, overall relapse-free, locoregional relapse-free and distant metastasis-free survival rates were 73.2, 66.8, 62.6, 67.4, and 86%, respectively. Patients with a lymph node ratio >0.09 experienced significantly worse outcomes. Univariate analysis showed that patients with previous radiotherapy, stage IV disease, nodal involvement, and lymphovascular invasion had significantly worse outcomes. Multivariate analysis focused naive patients and showed that lymphovascular invasion, advanced stage of disease, and node involvement resulted reliable prognostic factors, and patients with the same tumor stage and histological risk factors who did not undergo adjuvant therapy experienced significantly worse outcomes. In our series, surgery played a major role in the treatment of local extension; adjuvant therapy resulted strictly indicated in patients with advanced-stage disease associated with risk factors.
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Affiliation(s)
- Filippo Carta
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Daniela Quartu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Cinzia Mariani
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Melania Tatti
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Valeria Marrosu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Edoardo Gioia
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Clara Gerosa
- Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Jacopo S A Zanda
- Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Natalia Chuchueva
- ENT Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrea Figus
- Unit of Plastic Surgery, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
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Lucidi D, Fernandez IJ, Martone A, Molinari G, Bonali M, Villari D, Alicandri-Ciufelli M, Presutti L. Use of IMAGE1 S technology for detection of cholesteatoma in endoscopic ear surgery: a retrospective case series on 45 patients. Eur Arch Otorhinolaryngol 2020; 278:1373-1380. [PMID: 32666292 DOI: 10.1007/s00405-020-06204-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/08/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE To evaluate the role of selected modalities of Storz Professional Image Enhancement System (IMAGE1 S) in differentiating cholesteatoma during endoscopic ear surgery (EES); to assess the potential usefulness of IMAGE1 S in recognition of cholesteatoma residuals at the end of EES. METHODS A retrospective study on 45 consecutive patients who underwent EES for cholesteatoma between March 2019 and November 2019 at a tertiary referral center was performed. For each case, Spectra A and Spectra B filters were applied intra-operatively. When examining the surgical field, a switch from white light (WL) to IMAGE1 S was performed to detect cholesteatoma and differentiate it from non-cholesteatomatous tissue. When the IMAGE1 S pattern was suspicious for the presence of cholesteatoma, images of the field under both enhancement modalities were taken and the targeted lesions were sent for histologic analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of IMAGE1 S were calculated. A final recognition of the surgical field using the selected filters was performed to detect any possible cholesteatomatous residuals. RESULTS Detection of cholesteatoma by IMAGE1 S selected filters revealed the following data: sensitivity 97%, specificity 95%, PPV 95%, NPV 97%. On three occasions, there was no correspondence between enhanced endoscopy and histology. In 5 out of 45 cases (11%), cholesteatoma residuals, which had not been identified at WL inspection at the end of the procedure, were detected by IMAGE1 S. CONCLUSION Our results suggest a potential role for IMAGE1 S Spectra A and B filters in EES for cholesteatoma surgery. We propose the integration of IMAGE1 S as a final overview of the surgical cavity for recognition of cholesteatomatous residuals.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy.
| | - Ignacio Javier Fernandez
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Andrea Martone
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Giulia Molinari
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Marco Bonali
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Domenico Villari
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Matteo Alicandri-Ciufelli
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
| | - Livio Presutti
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy
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12
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Esmaeili N, Illanes A, Boese A, Davaris N, Arens C, Friebe M. A Preliminary Study on Automatic Characterization and Classification of Vascular Patterns of Contact Endoscopy Images .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2703-2706. [PMID: 31946453 DOI: 10.1109/embc.2019.8857145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The structure and organization of blood vessels in the vocal fold go through changes during the advancement from healthy to benign and further on to malignant stages. Contact Endoscopy (CE) is an optical technique providing real-time information related to the vascular structure of laryngeal mucosa. However, this technique comes with subjectivity in the interpretation of vascular patterns. In this study, a novel automated approach is proposed for vessel pattern charac-terization and classification of larynx CE + Narrow Band Imaging (NBI) images. This method is mainly based on the computation of indicators related to the level of disorder of vessels. 12 features were extracted from the indicators and were fed into two supervised classifiers. Linear Support Vector Machine (SVM) and K-Nearest Neighbor (KNN) showed an accuracy of 95.76% and 93.92% for vascular patterns and 86.04% and 82.23% for larynx histopathologies classification, respectively. These promising results show that the proposed method can potentially solve the subjectivity issues of CE.
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Mehlum CS, Døssing H, Davaris N, Giers A, Grøntved ÅM, Kjaergaard T, Möller S, Godballe C, Arens C. Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy. Eur Arch Otorhinolaryngol 2020; 277:2485-2492. [PMID: 32350646 DOI: 10.1007/s00405-020-06000-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/18/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Combined use of contact endoscopy (CE) and Narrow Band Imaging (NBI, Olympus®) is suggested for the visualization of specific vascular changes indicative of glottic neoplasia. We investigated the interrater reliability and agreement in 3 recognized classification systems of vascular changes applied to images from CE + NBI in patients suspected for glottic neoplasia. METHODS Six experienced head and neck surgeons familiar with NBI rated 120 images obtained by CE + NBI by 3 classification systems of vascular changes as suggested by Ni et al. (N-C), Puxeddu et al. (P-C), and the European Laryngological Society (ELS-C). Three raters were experienced in CE, and three raters had only limited experience with CE. Crude agreement and Fleiss' kappa with 95% confidence interval were estimated for all 6 raters, and for the 2 levels of expertise for each original classification system and for dichotomized versions of the N-C and the P-C based on suggested neoplastic potential. RESULTS The interrater crude agreement and the corresponding kappa values for the ELS-C were good and significantly higher than those for the N-C and P-C for all raters, irrespective of the level of experience with CE (p < 0.0001). There were no significant differences between the N-C and the P-C (p = 0.16). Kappa was considerably improved for both the N-C and the P-C to a level not different from the ELS-C (p = 0.21-0.71) when their 5 original categories were pooled into dichotomized classifications. CONCLUSION Difficulties in reliably classifying vascular changes in CE + NBI are evident. Two-tier classification systems are the most reliable.
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Affiliation(s)
- Camilla Slot Mehlum
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark.
| | - Helle Døssing
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Anja Giers
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Ågot Møller Grøntved
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology‑Head and Neck Surgery, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 165, 8200, Aarhus N, Denmark
| | - Sören Möller
- OPEN ‑ Open Patient Data Explorative Network and Department of Clinical Research, Odense University Hospital and University of Southern Denmark, J. B. Winsløwsvej 9, 5000, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
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14
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Abdullah B, Rasid NSA, Lazim NM, Volgger V, Betz CS, Mohammad ZW, Hassan NFHN. Ni endoscopic classification for Storz Professional Image Enhancement System (SPIES) endoscopy in the detection of upper aerodigestive tract (UADT) tumours. Sci Rep 2020; 10:6941. [PMID: 32332848 PMCID: PMC7181723 DOI: 10.1038/s41598-020-64011-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/07/2020] [Indexed: 12/31/2022] Open
Abstract
The diagnostic procedure for upper aerodigestive tract (UADT) tumours is by white light endoscopy (WLE) combined with biopsy. However, WLE has difficulty identifying minute epithelial changes which hinders early diagnosis. Storz Professional Image Enhancement System (SPIES) is designed to enhance the visualization of microvasculature on the mucosal surface and detect any epithelial changes. In this study, we aimed to evaluate the use of Ni endoscopic classification with SPIES endoscopy in the detection of UADT tumours. Fifty-nine patients with suspected UADT tumours underwent WLE followed by SPIES endoscopy. All the tumours were biopsied and sent for histopathological examination (HPE). The kappa index (κ) was used to evaluate the agreement between the methods. The level of agreement between SPIES using Ni classification and HPE showed almost perfect agreement as compared to moderate agreement between WLE and HPE. The sensitivity and specificity for WLE and HPE were 77.5% and 84.2% respectively with positive predictive value (PPV) of 91.2% and negative predictive value (NPV) of 64%. The sensitivity and specificity for SPIES endoscopy using Ni classification and HPE were 97.5% and 94.7% respectively with PPV of 97.5% and NPV of 94.7%. SPIES endoscopy using Ni classification is a valid tool for earlier tumour detection.
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Affiliation(s)
- Baharudin Abdullah
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Nurul Syeha Abdull Rasid
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Norhafiza Mat Lazim
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Veronika Volgger
- Department of Otorhinolaryngology Head & Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Christian Stephan Betz
- Department of Otorhinolaryngology, Universität sklinikum Hamburg-Eppendorf Head- and Neuro-Centre, Martinistraße 52, Building O10, 20246, Hamburg, Germany
| | - Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Nik Fariza Husna Nik Hassan
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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15
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Contact endoscopy for detection of residual or recurrent disease after radiotherapy for squamous cell carcinoma of the upper aerodigestive tract. The Journal of Laryngology & Otology 2020; 134:344-349. [PMID: 32238214 DOI: 10.1017/s0022215120000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate contact endoscopy in detecting local treatment failures post-radiotherapy in squamous cell carcinoma of the upper aerodigestive tract. METHOD A total of 135 consecutive patients with suspected residual or recurrent cancer after definitive radiotherapy underwent contact endoscopy before biopsy. Contact endoscopy findings were compared with histopathological examination findings. Contact endoscopy could not be completed in 7 patients (5.9 per cent) and histopathological examination was inconclusive in 5 patients (3.7 per cent). The findings of the remaining 123 patients were compared. RESULTS The sensitivity, specificity and accuracy of contact endoscopy were 88.75, 88.72 and 86.99 per cent, respectively, with similar results across various sites of upper aerodigestive tract. Inter-observer kappa value was 0.86 (95 per cent confidence interval: 0.79-0.93). The intra-observer kappa value was 0.93 (95 per cent confidence interval: 0.87-1.00) for the first observer and 0.95 (95 per cent confidence interval: 0.90-1.00) for second and third observers. CONCLUSION Contact endoscopy showed the same high sensitivity and specificity with low inter- and intra-observer variability in detecting post-radiotherapy failures in cancer of the upper aerodigestive tract as has been shown in non-irradiated tissues in earlier studies.
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16
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Cheng Y, Chen Y, Zang G, Chen B, Yao J, Zhang W, Wang H, Yu L, He P, Zhang Y, Wu H. Increased Expression of TAP Is Predictive of Poor Prognosis in Patients with Non-Small Cell Lung Cancer. Cancer Manag Res 2020; 12:1941-1946. [PMID: 32214851 PMCID: PMC7081064 DOI: 10.2147/cmar.s239593] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
Background The most common cancer among humans is lung cancer. Non-small cell lung cancer (NSCLC) comprises the majority of these cases. In the development and progression of cancers across the spectrum, tumor abnormal protein (TAP) plays crucial roles. Additionally, in the advancement of the bladder and colorectal cancers, the involvement of glycoproteins like TAP is present. However, it is worth noting that current literature has yet to clarify the clinical significance of the TAP in NSCLC. Methods In the present study, to evaluate the relative level of TAP, we utilized a TAP detection agent in 154 cases of NSCLC and normal patients who underwent surgical resection anytime from March 2013 to January 2019 at the People's Hospital of Chizhou. Results Our results demonstrated that in NSCLC patients, the expression level of TAP was significantly higher than in normal patients. Moreover, after surgery, TAP expression was significantly downregulated in NSCLC patients. TAP expression is associated with an array of factors, which include the patient's sex, history of smoking use, tumor size, pTNM, distant cancer, metastasis of lymph nodes, invasive and aggressive indicator pleural invasion, and differentiation degree of NSCLC. Additionally, TAP has no association with the patient's age, history of drinking, location of the tumor, hypertension, and diabetes. In NSCLC patients, a poor overall survival rate within 5 years is significantly correlated with the increased TAP expression. For NSCLC patients, an independent prognostic factor is the TAP, which is confirmed using the multivariate survival analysis. Conclusion In the malignant progression of NSCLC, our results demonstrate how the promoting role of the upregulated TAP expression takes place. Hence, a therapeutic aim for NSCLC and a potential biomarker for NSCLC progress is a TAP.
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Affiliation(s)
- Yuanjun Cheng
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Yongbing Chen
- Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Guohui Zang
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Bin Chen
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Jie Yao
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Wenguang Zhang
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Haibing Wang
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Liu Yu
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Pinghai He
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Youming Zhang
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
| | - Hanqing Wu
- Department of Cardiothoracic Surgery, People's Hospital of Chizhou, Chizhou, People's Republic of China
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Esmaeili N, Illanes A, Boese A, Davaris N, Arens C, Friebe M. Novel automated vessel pattern characterization of larynx contact endoscopic video images. Int J Comput Assist Radiol Surg 2019; 14:1751-1761. [PMID: 31352673 PMCID: PMC6797664 DOI: 10.1007/s11548-019-02034-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022]
Abstract
Purpose Contact endoscopy (CE) is a minimally invasive procedure providing real-time information about the cellular and vascular structure of the superficial layer of laryngeal mucosa. This method can be combined with optical enhancement methods such as narrow band imaging (NBI). However, these techniques have some problems like subjective interpretation of vascular patterns and difficulty in differentiation between benign and malignant lesions. We propose a novel automated approach for vessel pattern characterization of larynx CE + NBI images in order to solve these problems. Methods In this approach, five indicators were computed to characterize the level of vessel’s disorder based on evaluation of consistency of gradient and two-dimensional curvature analysis and then 24 features were extracted from these indicators. The method evaluated the ability of the extracted features to classify CE + NBI images based on the vascular pattern and based on the laryngeal lesions. Four datasets were generated from 32 patients involving 1485 images. The classification scenarios were implemented using four supervised classifiers. Results For classification of CE + NBI images based on the vascular pattern, polykernel support vector machine (SVM), SVM with radial basis function (RBF), k-nearest neighbor (kNN), and random forest (RF) show an accuracy of 97%, 96%, 96%, and 96%, respectively. For the classification based on the histopathology, Polykernel SVM showed an accuracy of 84%, 86% and 84%, RBF SVM showed an accuracy of 81%, 87% and 83%, kNN showed an accuracy of 89%, 87%, 91%, RF showed an accuracy of 90%, 88% and 91% for classification between benign histopathologies, between malignant histopathologies and between benign and malignant lesions, respectively. Conclusion These promising results show that the proposed method could solve the problem of subjectivity in interpretation of vascular patterns and also support the clinicians in the early detection of benign, pre-malignant and malignant lesions.
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Affiliation(s)
- Nazila Esmaeili
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
| | - Alfredo Illanes
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Axel Boese
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Magdeburg, Germany
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Magdeburg, Germany
| | - Michael Friebe
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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18
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Preference and Perception of Enhanced Images During Endonasal Endoscopic Surgery. J Craniofac Surg 2019; 29:2296-2298. [PMID: 30339600 DOI: 10.1097/scs.0000000000004801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Image enhancement is used widely in endoscopic sinonasal surgery. It is yet to be established whether image enhancement has advantages over white-light endoscopy. The authors aimed to evaluate the preferences and subjective visual perception of image enhancement in diagnostic images acquired at the beginning of endonasal endoscopic surgeries. An online survey consisting of 12 endoscopic images, 4 enhanced with Clara mode, 4 enhanced with Chroma mode, and 4 enhanced with Clara+Chroma mode, was distributed. The enhanced images were randomly presented with nonenhanced white-light images. These images were captured at the beginning of endonasal endoscopic surgeries for septal perforation, septal deviation, and chronic rhinosinusitis. Survey respondents (n = 205) included 81 otorhinolaryngologists, 94 other specialty physicians (35 endoscopy/laparoscopy users and 59 nonusers), and 30 nonmedical image experts. They were asked to choose superior images according to brightness, contrast and sharpness, depth of field, and overall preference. A quantitative study was also conducted to evaluate different enhancement modes. The authors found that Clara enhanced brightness and Chroma enhanced contrast and sharpness significantly (P < 0.001). Overall, 91.8% chose Clara and 91.7% chose Clara+Chroma-enhanced images for brightness enhancement. For contrast and sharpness, 87% chose Clara+Chroma and 86.7% chose Chroma. There was no significant difference between perception scores among the groups. Our survey group showed a significantly high overall preference for enhanced images. This preference was independent of profession or experience, but closely related to the quantitative enhancement of the specific mode. Continuous use of image enhancement in endonasal surgery may have advantages over white-light endoscopy.
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Carta F, Farneti P, Cantore S, Macrì G, Chuchueva N, Cuffaro L, Pasquini E, Puxeddu R. Sialendoscopy for salivary stones: principles, technical skills and therapeutic experience. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:102-112. [PMID: 28516972 PMCID: PMC5463517 DOI: 10.14639/0392-100x-1599] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022]
Abstract
Obstructive sialadenitis is the most common non-neoplastic disease of the salivary glands, and sialendoscopy is increasingly used in both diagnosis and treatment, associated in selected cases with endoscopic laser lithotripsy. Sialendoscopy is also used for combined minimally invasive external and endoscopic approaches in patients with larger and proximal stones that would require excessively long laser procedures. The present paper reports on the technical experience from the Ear, Nose and Throat Unit of the Sant'Orsola-Malpighi Hospital of Bologna, and from the Department of Otorhinolaryngology of the University Hospital of Cagliari, Italy, including the retrospective analysis of the endoscopic and endoscopic assisted procedures performed on 48 patients (26 females and 22 males; median age 45.3; range 8-83 years) treated for chronic obstructive sialadenitis at the University Hospital of Cagliari from November 2010 to April 2016. The results from the Sant'Orsola-Malpighi Hospital of Bologna have been previously published. The technical aspects of sialendoscopy are carefully described. The retrospective analysis of the University Hospital of Cagliari shows that the disease was unilateral in 40 patients and bilateral in 8; a total of 56 major salivary glands were treated (22 submandibular glands and 34 parotids). Five patients underwent bilateral sialendoscopy for juvenile recurrent parotitis. 10 patients were treated for non-lithiasic obstructive disease. In 33 patients (68.75%) the obstruction was caused by salivary stones (bilateral parotid lithiasis in 1 case). Only 8 patients needed a sialectomy (5 submandibular glands and 3 parotids). The conservative approach to obstructive sialadenitis is feasible and can be performed either purely endoscopically or in a combined modality, with a high percentage of success. The procedure must be performed with dedicated instrumentation by a skilled surgeon after proper training since minor to major complications can be encountered. Sialectomy should be the "extrema ratio" after failure of a conservative approach.
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Affiliation(s)
- F Carta
- Department of Otorhinolaryngology, University of Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Italy
| | - P Farneti
- Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - S Cantore
- Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - G Macrì
- Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - N Chuchueva
- Department of Otorhinolaryngology, University of Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Italy.,I.M. Sechenov First Moscow State Medical University, 11991, Moscow, Russia
| | - L Cuffaro
- Department of Otorhinolaryngology, University of Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Italy
| | - E Pasquini
- Ear, Nose and Throat Metropolitan Unit - Surgical Department - AUSL Bologna, Bellaria Hospital, Bologna, Italy
| | - R Puxeddu
- Department of Otorhinolaryngology, University of Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Italy
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20
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Miyamoto I, Yada N, Osawa K, Yoshioka I. Endocytoscopy for in situ real-time histology of oral mucosal lesions. Int J Oral Maxillofac Surg 2018; 47:896-899. [PMID: 29625719 DOI: 10.1016/j.ijom.2018.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/26/2018] [Accepted: 03/13/2018] [Indexed: 12/14/2022]
Abstract
This study investigated the utility of endocytoscopy, a novel emerging endoscopic system, for in situ real-time histology of oral mucosal lesions. Endocytoscopy involves the use of a contact light microscopy system with 380-fold magnification. With the development of endoscopic instruments, it has become possible to observe the abnormal microvascular and capillary patterns of tumour cells. The resolution of the endoscopic image is improved in situ, and a more detailed diagnosis is possible. In this study, endocytoscopy along with other diagnostic modalities was used in nine patients. Normal mucous membranes and oral malignant lesions were observed. Endocytoscopy enabled the pathological diagnosis of oral malignancies in situ and the observation of both structural and cytological atypia. In the future, it is expected that pathological diagnoses will be made in situ by direct viewing of living cells. This technique has the potential to allow an 'optical biopsy'.
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Affiliation(s)
- I Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan.
| | - N Yada
- Division of Oral Pathology, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - K Osawa
- Division of Oral Medicine, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - I Yoshioka
- Division of Oral Medicine, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
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21
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Tirelli G, Piovesana M, Marcuzzo AV, Gatto A, Biasotto M, Bussani R, Zandonà L, Giudici F, Boscolo Nata F. Tailored resections in oral and oropharyngeal cancer using narrow band imaging. Am J Otolaryngol 2018; 39:197-203. [PMID: 29150027 DOI: 10.1016/j.amjoto.2017.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/28/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study. MATERIALS AND METHODS The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded. RESULTS We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site. CONCLUSIONS NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.
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22
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Sun C, Deng F, Meng L, Chen G. Correlation between TAP detection and common digestive tract precancerous lesions. Oncol Lett 2017; 15:1616-1620. [PMID: 29434857 PMCID: PMC5774502 DOI: 10.3892/ol.2017.7496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/14/2017] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to investigate the clinical significance of abnormal sugar-chain glycoprotein tumor abnormal protein (TAP) in the screening of common digestive tract pre-cancer colon adenocarcinoma lesions. A total of 50 colitis patients, 50 colon polyp patients and 50 colon adenocarcinoma patients admitted to our hospital from March, 2012 to May, 2014 were included. Fresh blood from patient's fingertips was collected and condensation staining was used to detect TAP expression. Positive expressions of TAP in patients in the colitis, colon polyp and colon adenocarcinoma groups prior to treatment were 6,76 and 92%, respectively. The TAP-positive expression rate comparisons between the three groups were statistically significant (P<0.05), and TAP-positive expression showed an increasing trend. TAP-positive expression was not significantly correlated with sex, age or ethnic group (P>0.05). Patient follow-up revealed that the tumor incidence rate in TAP-positive patients was significantly higher than that in TAP-negative in the colitis and colon polyp groups (P<0.05), and the postoperative tumor recurrence rate in TAP-positive patients was significantly higher than that in TAP-negative in the colon adenocarcinoma group (P<0.05). TAP had a higher expression in colon pre-adenocarcinoma lesions. Additionally, TAP participated in the processes from intestinal mucosal inflammation to colon polyp formation to tissue canceration, and was correlated with these. Thus, TAP can be used for the screening of digestive tract precancerous lesions.
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Affiliation(s)
- Changqing Sun
- Department of Oncology, Dezhou People's Hospital, Dezhou, Shandong 253000, P.R. China
| | - Fang Deng
- Department of Oncology, Dezhou People's Hospital, Dezhou, Shandong 253000, P.R. China
| | - Lingjun Meng
- Department of Oncology, Dezhou People's Hospital, Dezhou, Shandong 253000, P.R. China
| | - Guohua Chen
- Department of Oncology, Dezhou People's Hospital, Dezhou, Shandong 253000, P.R. China
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23
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Mehlum CS, Rosenberg T, Dyrvig AK, Groentved AM, Kjaergaard T, Godballe C. Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis. Laryngoscope 2017; 128:168-176. [DOI: 10.1002/lary.26721] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/23/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Camilla S. Mehlum
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | - Tine Rosenberg
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | | | - Aagot Moeller Groentved
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology-Head and Neck Surgery; Aarhus University Hospital; Aarhus Denmark
| | - Christian Godballe
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
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