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窄带成像引导下的切除术是实现口腔和口咽鳞状细胞癌切缘足够的一项突破吗?

Is NBI-Guided Resection a Breakthrough for Achieving Adequate Resection Margins in Oral and Oropharyngeal Squamous Cell Carcinoma?

作者信息

Tirelli Giancarlo, Piovesana Marco, Gatto Annalisa, Torelli Lucio, Boscolo Nata Francesca

机构信息

ENT Clinic, Head and Neck Department, University of Trieste, Italy.

Department of Mathematics and Earth Science, University of Trieste, Italy.

出版信息

Ann Otol Rhinol Laryngol. 2016 Jul;125(7):596-601. doi: 10.1177/0003489416641428. Epub 2016 Apr 7.

Abstract

OBJECTIVES

Obtaining free resection margins is the main goal of oncological surgeons. Narrow-band imaging (NBI) has been recently used to help define resection margins in transoral laser microsurgery for laryngeal carcinoma. The aim of this study was to evaluate the effect of intraoperative NBI in defining the surgical resection margins of oral and oropharyngeal cancers.

METHODS

Between January 2014 and March 2015, NBI was used intraoperatively after an initial definition of resection margins with white light in 26 patients (group A). The rate of superficial positive margins at definitive histology was compared with that of a historical cohort of 44 patients (group B) previously managed without the use of intraoperative NBI.

RESULTS

A statistically significant reduction in the rate of positive superficial margins was observed at definitive histology in group A (P = .028). NBI helped to identify the presence of dysplasia and cancer around the visible tumor not otherwise detectable with visual examination alone.

CONCLUSIONS

NBI could be a useful tool for obtaining free resection margins in oral and oropharyngeal carcinoma.

摘要

目的

获得切缘阴性是肿瘤外科医生的主要目标。窄带成像(NBI)最近已被用于在喉癌经口激光显微手术中帮助确定切除边缘。本研究的目的是评估术中NBI在确定口腔和口咽癌手术切除边缘方面的效果。

方法

在2014年1月至2015年3月期间,26例患者(A组)在最初用白光确定切除边缘后术中使用NBI。将最终组织学检查时浅表切缘阳性率与44例既往未使用术中NBI治疗的患者(B组)的历史队列进行比较。

结果

在A组最终组织学检查中观察到浅表切缘阳性率有统计学意义的降低(P = .028)。NBI有助于识别在仅通过视觉检查无法检测到的可见肿瘤周围发育异常和癌症的存在。

结论

NBI可能是获得口腔和口咽癌切缘阴性的有用工具。

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