Detection of early laryngeal cancer and its precursor lesions by a real-time autofluorescence imaging system.

The prognosis of laryngeal carcinoma patients can be improved by early diagnosis. The autofluorescence endoscopy has been developed to gain more information about the biologic character of the precancerous or cancerous lesions. The aim of the present study was to evaluate the diagnostic potential and limitations of this imaging technique applied during indirect laryngoscopy and comparing with white light and microlaryngoscopy with biopsy. In a prospective study, 56 patients with suspected precancerous or cancerous lesions were investigated preoperatively by white light and fluorescence endoscopy during indirect laryngoscopy. The procedure was followed by microlaryngoscopy and biopsy. Results were compared to histopathological findings. Normal laryngeal mucosa displayed a typical green fluorescence, moderate to high epithelial dysplasia, in situ carcinoma and cancer showed a diminished green fluorescence. In 47 of 56 (84%) cases, we found concordant results. The experience from this study shows that autofluorescence by indirect laryngoscopy may be a useful complementary method for detecting laryngeal malignancies. Its advantages are non-invasiveness, high sensitivity and repeatability.