Yang Shih-Wei, Lee Yun-Shien, Chang Liang-Che, Hwang Cheng-Cheng, Chen Tai-An
Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, No. 222, Mai Chin Road, Keelung 204, Taiwan, Republic of China,
Clin Oral Investig. 2014 Apr;18(3):949-59. doi: 10.1007/s00784-013-1027-y. Epub 2013 Jul 9.
This study seeks to analyze the factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers for more than 3 weeks and investigate the role of endoscopy with narrow-band imaging system (NBI) in detecting carcinoma in these lesions.
The demographic and clinicopathological data of patients receiving surgical interventions for chronic oral non-healing ulcers, and the intraepithelial papillary capillary loop patterns shown by NBI were retrospectively reviewed and analyzed.
A total of 63 patients (41 males and 22 females) with mean age of 57.9 ± 16.7 years were enrolled. In univariate analysis, ulcers with induration, history of oral cancer, and intraepithelial microvasculature of NBI were factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers. Multivariate analysis showed that the intraepithelial microvasculature of NBI was the only independent factor predicting the occurrence of carcinoma in oral chronic non-healing ulcers with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.75 %, 91.49 %, 78.95 %, 97.73 %, and 92.06 %, respectively.
Morphology of intraepithelial microvasculature of NBI, or twisted, elongated, and destructive pattern of intraepithelial papillary capillary loop, is the only independent factor associated with the occurrence of squamous cell carcinoma in oral chronic non-healing ulcers. Endoscope with NBI is a rapid, safe, and promising tool in detecting squamous cell carcinoma in oral chronic non-healing ulcers.
本研究旨在分析与持续3周以上不愈合的口腔溃疡发生鳞状细胞癌相关的因素，并探讨窄带成像系统（NBI）内镜检查在检测这些病变中癌变的作用。
回顾性分析接受慢性口腔不愈合溃疡手术干预患者的人口统计学和临床病理数据，以及NBI显示的上皮内乳头毛细血管袢模式。
共纳入63例患者（男性41例，女性22例），平均年龄57.9±16.7岁。单因素分析显示，伴有硬结的溃疡、口腔癌病史以及NBI的上皮内微血管是与口腔不愈合溃疡发生鳞状细胞癌相关的因素。多因素分析表明，NBI的上皮内微血管是预测口腔慢性不愈合溃疡癌变的唯一独立因素，其敏感度、特异度、阳性预测值、阴性预测值和准确度分别为93.75%、91.49%、78.95%、97.73%和92.06%。
NBI的上皮内微血管形态，即上皮内乳头毛细血管袢扭曲、延长和破坏模式，是与口腔慢性不愈合溃疡发生鳞状细胞癌相关的唯一独立因素。带NBI的内镜是检测口腔慢性不愈合溃疡鳞状细胞癌的一种快速、安全且有前景的工具。
