Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Department of Otorhinolaryngology Head & Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany.
Sci Rep. 2020 Apr 24;10(1):6941. doi: 10.1038/s41598-020-64011-6.
The diagnostic procedure for upper aerodigestive tract (UADT) tumours is by white light endoscopy (WLE) combined with biopsy. However, WLE has difficulty identifying minute epithelial changes which hinders early diagnosis. Storz Professional Image Enhancement System (SPIES) is designed to enhance the visualization of microvasculature on the mucosal surface and detect any epithelial changes. In this study, we aimed to evaluate the use of Ni endoscopic classification with SPIES endoscopy in the detection of UADT tumours. Fifty-nine patients with suspected UADT tumours underwent WLE followed by SPIES endoscopy. All the tumours were biopsied and sent for histopathological examination (HPE). The kappa index (κ) was used to evaluate the agreement between the methods. The level of agreement between SPIES using Ni classification and HPE showed almost perfect agreement as compared to moderate agreement between WLE and HPE. The sensitivity and specificity for WLE and HPE were 77.5% and 84.2% respectively with positive predictive value (PPV) of 91.2% and negative predictive value (NPV) of 64%. The sensitivity and specificity for SPIES endoscopy using Ni classification and HPE were 97.5% and 94.7% respectively with PPV of 97.5% and NPV of 94.7%. SPIES endoscopy using Ni classification is a valid tool for earlier tumour detection.
上呼吸道-消化道（UADT）肿瘤的诊断程序是通过白光内窥镜（WLE）结合活检进行的。然而，WLE 难以识别微小的上皮变化，这阻碍了早期诊断。STORZ 专业图像增强系统（SPIES）旨在增强黏膜表面微血管的可视化效果，并检测任何上皮变化。在这项研究中，我们旨在评估使用 Ni 内镜分类与 SPIES 内镜检测 UADT 肿瘤的效果。59 例疑似 UADT 肿瘤的患者接受了 WLE 检查，随后进行了 SPIES 内镜检查。所有肿瘤均进行了活检，并送组织病理学检查（HPE）。使用 Kappa 指数（κ）评估两种方法的一致性。与 WLE 和 HPE 之间的中度一致性相比，SPIES 使用 Ni 分类与 HPE 之间的一致性几乎是完美的。WLE 和 HPE 的敏感性和特异性分别为 77.5%和 84.2%，阳性预测值（PPV）为 91.2%，阴性预测值（NPV）为 64%。SPIES 内镜使用 Ni 分类与 HPE 的敏感性和特异性分别为 97.5%和 94.7%，PPV 为 97.5%，NPV 为 94.7%。SPIES 内镜使用 Ni 分类是一种更早发现肿瘤的有效工具。
