Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany.
Laryngoscope. 2010 Oct;120(10):1964-70. doi: 10.1002/lary.21057.
OBJECTIVES/HYPOTHESIS: A newly developed microscope-based spectral-domain optical coherence tomography (SD-OCT) device and an endoscope-based time-domain OCT (TD-OCT) were used to assess the inter-rater reliability, sensitivity, specificity, and accuracy of benign and dysplastic laryngeal epithelial lesions.
Prospective study.
OCT during microlaryngoscopy was done on 35 patients with an endoscope-based TD-OCT, and on 26 patients by an SD-OCT system integrated into an operating microscope. Biopsies were taken from microscopically suspicious lesions allowing comparative study of OCT images and histology.
Thickness of the epithelium was seen to be the main criterion for degree of dysplasia. The inter-rater reliability for two observers was found to be kappa = 0.74 (P <.001) for OCT. OCT provided test outcomes for differentiation between benign laryngeal lesions and dysplasia/CIS with sensitivity of 88%, specificity of 89%, PPV of 85%, NPV of 91%, and predictive accuracy of 88%. However, because of the limited penetration depth of the laser light primarily in hyperkeratotic lesions (thickness above 1.5 mm), the basal cell layer was no longer visible, precluding reliable assessment of such lesions.
OCT allows for a fairly accurate assessment of benign and dysplastic laryngeal epithelial lesion and greatly facilitates the taking of precise biopsies. Laryngoscope, 2010.
目的/假设：本研究采用新开发的基于显微镜的光谱域光相干断层扫描（SD-OCT）设备和基于内镜的时域 OCT（TD-OCT），评估良性和异型性喉上皮病变的观察者间可靠性、敏感性、特异性和准确性。
前瞻性研究。
对 35 例患者进行内镜 TD-OCT 检查和 26 例患者进行显微镜集成 SD-OCT 系统检查，通过显微镜检查可疑病变进行 OCT 检查。对疑似病变进行活检，以比较 OCT 图像和组织学。
上皮厚度被认为是异型性程度的主要标准。两名观察者的观察者间可靠性为 kappa = 0.74（P <.001）。OCT 可用于区分良性喉病变和异型性/原位癌，其敏感性为 88%，特异性为 89%，阳性预测值为 85%，阴性预测值为 91%，预测准确性为 88%。然而，由于激光光的穿透深度有限，主要在角化过度病变（厚度超过 1.5 毫米）中，基底细胞层不再可见，从而无法对这些病变进行可靠的评估。
OCT 可相当准确地评估良性和异型性喉上皮病变，并极大地促进了精确活检的进行。喉镜，2010。
