Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.
Otolaryngol Head Neck Surg. 2010 Mar;142(3 Suppl 1):S20-6. doi: 10.1016/j.otohns.2009.12.021.
Panendoscopy is used in selected patients with head and neck cancer to detect second primary disease. We hypothesized that adding autofluorescence to the bronchoscopy and laryngoscopy part of this procedure could add to the detection of clinically meaningful dysplasias and carcinomas in both the head and neck and bronchus, with resultant change in management.
Prospective observational study on consecutive patients with head and neck cancer who had panendoscopy prior to surgery.
Teaching hospital, tertiary referral center.
All patients had white-light inspection observed by ENT surgeons, followed by autofluorescence inspection of the head and neck tumor and surrounding area as well as the bronchus. Extra biopsies were taken from regions of abnormal fluorescence where there was no white-light abnormality.
Sixty-six patients were studied; mean age 64.9 +/- 11 years. As a result of autofluorescence, 33 mucosal biopsies were taken from the head and neck and 37 from the bronchus. Histology included three carcinoma in situ lesions and four severe dysplasias. As a result of these autofluorescence biopsies, change of management occurred in four patients (6% of the total patients). Standard panendoscopy changed management in five patients. Therefore, standard panendoscopy led to change in management in only 55 percent of cases (CI 21%-86%, P = 0.02), with the rest detected by autofluorescence.
Adding autofluorescence to panendoscopy in patients with head and neck cancer changed management in a clinically significant number of patients.
在选择的头颈部癌症患者中使用全景内镜检查来检测第二原发疾病。我们假设在该程序的支气管镜和喉镜部分添加荧光检查可以增加对头颈部和支气管中具有临床意义的发育异常和癌的检测，并因此改变管理。
对术前接受全景内镜检查的连续头颈部癌症患者进行前瞻性观察性研究。
教学医院，三级转诊中心。
所有患者均接受耳鼻喉科外科医生进行的白光检查，然后对头颈部肿瘤及其周围区域以及支气管进行荧光检查。在白光异常无异常的荧光区域进行额外的活检。
共研究了 66 例患者；平均年龄 64.9 +/- 11 岁。由于荧光检查，从头颈部和支气管分别取了 33 个粘膜活检。组织学包括三个原位癌病变和四个严重发育不良。由于这些荧光活检，有 4 名患者（占总患者的 6%）的治疗方案发生了改变。标准全景内镜检查改变了 5 名患者的治疗方案。因此，标准全景内镜检查仅导致 55%（CI 21%-86%，P = 0.02）的病例改变了治疗方案，其余病例则通过荧光检查检测到。
在头颈部癌症患者中添加荧光检查可使相当数量的患者的治疗方案发生改变。
