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Deva FAL. Narrow Band Imaging Technology: Role in the Detection of Recurrent Laryngeal and Hypopharyngeal Cancers Post-radiotherapy. Indian J Otolaryngol Head Neck Surg 2023; 75:753-759. [PMID: 37275073 PMCID: PMC10235265 DOI: 10.1007/s12070-022-03457-8] [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: 03/22/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
To assess the diagnostic accuracy of NBI endoscopy for the diagnosis of early recurrent laryngeal and hypopharyngeal cancers after radiotherapy. The study was conducted over a period of two and a half years from June 2019 to February 2022 and included 123 post-RT patients with laryngeal and hypopharyngeal cancers. The patients were planned for endoscopy with white light and narrow-band imaging. The biopsy was carried out in NBI suspected lesions and sent for histopathological examination. The pathologist was blinded to the outcome of NBI and WLE results to eliminate observer bias. The age group most commonly affected in our study was 40-50 years. Out of the 123 patients, 106 were males and 17 were females. The overall Sensitivity, Specificity, Positive predictive value and Negative predictive value of NBI for malignant lesions were 90.6%, 99%, 95.2% and 98% respectively. NBI Technology is a first-rate diagnostic tool that can help in diagnosing early recurrent cancer lesions, especially after RT, in which the recurrence is otherwise difficult to differentiate from post-radiotherapy oedema. This technology can significantly reduce the rates of failure to detect cancers in early stages.
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Kántor P, Staníková L, Lubojacký J, Masárová M, Zeleník K, Komínek P. Evolution of mucosal vasculature after radiotherapy of T1 vocal cord cancer: a pilot study. Eur Arch Otorhinolaryngol 2023; 280:1321-1327. [PMID: 36197583 PMCID: PMC9899745 DOI: 10.1007/s00405-022-07680-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Narrow-band imaging is the state of the art in the diagnosis of mucosal lesions of the vocal cords. It is also used in the follow-up of patients after surgical therapy. Unfortunately, if a patient has received radiotherapy the follow-up is much more difficult. Radiation induces inflammatory changes in the mucosa, which lead to changes in the vascular architecture and thus affect the results of the examination. The dynamics and time dependence of vascular changes after radiotherapy have not yet been described. The purpose of this study is to describe the evolution of the vascular pattern in vocal cords after primary radiotherapy for glottic cancer. METHODS This was a retrospective cohort study. Each patient underwent NBI videolaryngoscopy and was followed every 3 months. RESULTS The tumor-related mucosal changes diminished at 3 months after radiotherapy. Afterward, growth of new longitudinal vasculature was observed and significantly slowed after 9 months. No perpendicular vasculature or tumor recurrence was observed during the course of the study. CONCLUSIONS According to our data, we can conclude that post-radiation mucosal vasculature changes are only longitudinal.
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Affiliation(s)
- Peter Kántor
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic
| | - Lucia Staníková
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic
| | - Jakub Lubojacký
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
| | - Michaela Masárová
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
| | - Karol Zeleník
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790/5, 70800 Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic
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Huang X, Chen R, Zhao L. Diagnostic Value of Endoscopic Narrow-Band Imaging Technique in Early Gastric Cancer and Precancerous Lesions. SCANNING 2022; 2022:9205150. [PMID: 36111267 PMCID: PMC9448607 DOI: 10.1155/2022/9205150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/05/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Objective To investigate the diagnostic value of endoscopic narrow-band imaging technique in early gastric cancer and precancerous lesions. Methods A total of 100 patients with recurrent upper gastrointestinal symptoms in our hospital from January 2017 to January 2022 were selected and divided into group A and group B according to the random number table method, with 50 cases in each group. Group A received white light endoscopy, and group B received narrow-band imaging technology combined with endoscopy. Narrow-band imaging combined with magnifying endoscopy was used to stain the area with suspicious mucosal lesions with indigo carmine and magnified observation. Results The endoscopic image clarity of group B was significantly better than that of group A in terms of lesion outline, gastric pit, and microvascular morphology (P < 0.05). There were 10 cases of early gastric cancer, 18 cases of benign lesions, and 9 cases of gastric cancer (nonearly stage); 17 cases of precancerous lesions, 12 cases of early gastric cancer, 13 cases of benign lesions, and 6 cases of gastric cancer (nonearly stage) were diagnosed by ordinary white light endoscopy. Pathological results confirmed that among the 50 patients in group B, there were 15 cases of precancerous lesions, 11 cases of early gastric cancer, 17 cases of benign lesions, and 7 cases of gastric cancer (nonearly stage). Among the 50 patients in group A, 16 were precancerous lesions, 11 were early gastric cancer, 15 were benign lesions, and 8 were gastric cancer (non early stage). In the diagnosis of precancerous lesions and early gastric cancer, the diagnostic consistency, sensitivity, and specificity of group B were better than those of group A (P < 0.05); NBI combined with endoscopy in the diagnosis of precancerous lesions and early gastric cancer (kappa = 0.860, kappa = 0.883) was more consistent with pathological diagnosis than common white light endoscopy (kappa = 0.433, kappa = 0.535). Conclusion The value of narrow-band imaging technology combined with endoscopy in the diagnosis of precancerous lesions and early gastric cancer is better than that of ordinary white light endoscopy, and it can be widely used in clinical practice.
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Affiliation(s)
- Xianxin Huang
- Dongdong Medical Group Downtown Hospital, Huangshi, Hubei 435000, China
| | - Rong Chen
- Dongdong Medical Group Downtown Hospital, Huangshi, Hubei 435000, China
| | - Liang Zhao
- Dongdong Medical Group Downtown Hospital, Huangshi, Hubei 435000, China
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Szczepanek E, Drozd-Sokołowska J, Sokołowski J, Rzepakowska A, Moskwa A, Pachla J, Grzybowski J, Woźnica K, Niemczyk K, Jamroziak K. Solitary Extramedullary Plasmacytoma of the Larynx and Secondary Laryngeal Involvement in Plasma Cell Myeloma: Single-Centre Retrospective Analysis and Systematic Literature Review. J Clin Med 2022; 11:jcm11154390. [PMID: 35956004 PMCID: PMC9369432 DOI: 10.3390/jcm11154390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
The involvement of the larynx in plasma cell myeloma (PCM) may manifest as solitary extramedullary plasmacytoma of the larynx (sEMP-L) or as infiltration of the larynx during newly diagnosed or relapsed systemic disease with bone marrow involvement (plasma cell myeloma with laryngeal involvement, PCM-L). To increase knowledge about these rare conditions, we performed a retrospective analysis along with a comprehensive literature review of cases of sEMP-L or PCM-L. Six patients (two sEMP-L and four PCM-L) were identified in our tertiary laryngological centre from 2009 to 2021, constituting 0.88% of all malignant laryngeal tumours. The literature search yielded 187 cases, including 152 sEMP-L and 35 sPCM-L. A comparison of baseline characteristics between sEMP-L and PCM-L performed in the combined cohort of cases from literature review and retrospective analysis revealed that patients with sEMP-L were younger (56 vs. 64 years, p ≤ 0.001) and presented less commonly with thyroid or cricoid cartilage involvement (2.2% vs. 30.8%, p ≤ 0.001). The prognosis of sEMP-L was better than PCM-L (overall survival 86% vs. 55% at 5 years, p = 0.002). Analysis of potential factors that could influence progression-free survival (PFS) in the group of sEMP-L revealed that male sex and cartilage involvement negatively affected PFS in univariate analyses, while only cartilage involvement retained statistical significance in multivariate analysis (HR = 19.94, p = 0.024). In conclusion, PCM with laryngeal involvement is sporadic. Secondary involvement of the larynx during PCM might be more common than sEMP-L and is associated with worse survival. The involvement of cartilage adversely influences the outcome of sEMP-L.
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Affiliation(s)
- Elżbieta Szczepanek
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
- Doctoral School in Medical Sciences and Health Sciences, Jagiellonian University Medical College, 31-530 Cracow, Poland
- Correspondence: ; Tel.: +48-660-107-595
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.D.-S.); (K.J.)
| | - Jacek Sokołowski
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
| | - Anna Rzepakowska
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
| | - Arkadiusz Moskwa
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
| | - Jakub Pachla
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
| | - Jakub Grzybowski
- Department of Pathology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Katarzyna Woźnica
- Faculty of Mathematics and Information Science, Warsaw University of Technology, 00-661 Warsaw, Poland;
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.S.); (A.R.); (A.M.); (J.P.); (K.N.)
| | - Krzysztof Jamroziak
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.D.-S.); (K.J.)
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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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Sun C, Hu L, Miao Z. Diagnostic performance of NBI in post-treatment follow up for laryngeal cancer: A systematic review and meta-analysis. Am J Otolaryngol 2022; 43:103530. [DOI: 10.1016/j.amjoto.2022.103530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/01/2022]
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Klimza H, Jackowska J, Pietruszewska W, Rzepakowska A, Wierzbicka M. The Narrow Band Imaging as an essential complement to White Light Endoscopy in Recurrent Respiratory Papillomatosis diagnostics and follow-up process. Otolaryngol Pol 2021; 76:1-5. [DOI: 10.5604/01.3001.0015.4540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study is to discuss the role of NBI imaging in upper respiratory papillomatosis (RRP). In the available literature on the subject, as of 2009, there have been 117 publications on NBI imaging focusing on the diagnosis of the upper respiratory and digestive tract, especially the larynx. They discuss the following diagnostic and therapeutic problems: identifying an abnormal vascular pattern within the mucosa, differentiating benign and malignant lesions, assessing the nature of lesions under the leukoplakia plaque, pre-operative definition of laryngeal cancer margins, supporting laser procedures to obtain safe margins, postoperative monitoring after cancer treatment, detecting second simultaneous and metachronic neoplasms and primary tumors in the case of metastases from an unknown primary site. Few reports have been devoted to the assessment of the extent and recurrence of RRP. Due to its recurrent nature, this pathology deserves special attention as it requires multiple inspections and manipulation within the larynx. It also applies to the pediatric population, where there should be no margin for underestimating or overestimating changes, because any suspicion of recurrence results in subsequent general anesthesia. Hence the attempt to define an unambiguous picture of RRP recurrence and the criteria for referring for subsequent surgical treatment.
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Affiliation(s)
- Hanna Klimza
- Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
| | - Joanna Jackowska
- Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Poland
| | | | - Małgorzata Wierzbicka
- Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poland
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Diagnostic value of autofluorescence laryngoscope in early laryngeal carcinoma and precancerous lesions: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2021; 35:102460. [PMID: 34329763 DOI: 10.1016/j.pdpdt.2021.102460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We aim to evaluate the diagnostic value of autofluorescence laryngoscope (AFL) in early laryngeal carcinoma and precancerous lesions. aWe also assess the value of AFL in diagnosis of early laryngeal carcinoma and precancerous lesions in comparison with that of white light laryngoscope (WL). METHODS The databases consisting of PubMed, Cochrane Library, Web of science and CNKI were systematically searched to find pertinent literatures of AFL in diagnosing early laryngeal carcinoma and precancerous lesions. We made a quality evaluation of every study we included using the modified Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled sensitivities, specificities were calculated using Meta-Disc 1.4. And we estimated the summary receiver operating characteristic curves (SROC) and area under the curves (AUC). RESULTS We finally included 23 studies. The results of AFL in diagnosing early laryngeal carcinoma and precancerous lesions showed higher sensitivity of 0.91 (95%CI: 0.89-0.93; χ²=43.78, p = 0.0025) and specificity of 0.80 (95%CI: 0.77-0.82; χ²=130.64, p = 0.000), and the weighted AUC of AFL was 0.948 ± 0.013 (95%CI: 0.921-0.974) and the diagnostic accuracy (Q*) was 0.887 ± 0.018. The sensitivity and specificity of WL were 0.74 (95%CI: 0.70-0.77; χ²=52.40, p = 0.000) and 0.89 (95%CI: 0.87-0.90; χ²=299.22, p = 0.000), and the weighted AUC of WL was 0.835 ± 0.029 (95%CI: 0.777-0.892) and the diagnostic accuracy (Q*) was 0.767 ± 0.027. CONCLUSION The meta-analysis and systematic review suggested that AFL had high diagnostic value in early laryngeal carcinoma and precancerous lesions, and its diagnostic value was higher than that of WL. These results indicated that AFL can provide good guidance for the early detection of laryngeal carcinoma and precancerous lesions.
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