窄带成像技术在口腔扁平苔藓患者中的诊断准确性：一项前瞻性研究。
Diagnostic Accuracy of Narrow Band Imaging in Patients with Oral Lichen Planus: A Prospective Study.
机构信息
Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Cremona, Italy.
出版信息
Laryngoscope. 2021 Apr;131(4):E1156-E1161. doi: 10.1002/lary.29035. Epub 2020 Aug 14.
OBJECTIVE
Oral lichen planus (OLP) is a chronic mucocutaneous immune-mediated disease affecting 1% to 4% of the worldwide population. Development of malignant lesions is reported but only affects a minority of patients. The aim of our study was to assess the diagnostic potential of narrow band imaging (NBI) in OLP patients; focusing on the identification of high-grade dysplasia/carcinoma in newly developed lesions.
METHODS
Prospective evaluation of 56 patients with histopathologic diagnosis of OLP and presenting newly developed lesions not responding to medical treatment. All lesions were assessed by high-definition (HD) white light (WL) and HD-NBI endoscopy. All patients underwent biopsy regardless of the appearance at HD-WL and HD-NBI. Histology was defined as "positive" in case of high-grade dysplasia or carcinoma.
RESULTS
Five lesions (9%) were diagnosed as high-grade dysplasia/carcinoma. In this setting, overall diagnostic potential of HD-NBI was optimal, with a sensitivity of 100% (95% CI, 48-100), specificity of 96% (95% CI, 86-99), negative predictive value of 100% (95% CI, not calculable), positive predictive value of 71% (95% CI, 39-91), and accuracy of 96% (95% CI, 88-100).
CONCLUSIONS
Despite the diffuse inflammatory pattern derived from OLP, NBI improved the diagnostic accuracy and the capability to detect high-grade dysplasia/carcinoma.
LEVEL OF EVIDENCE
4 Laryngoscope, 131:E1156-E1161, 2021.
目的
口腔扁平苔藓（OLP）是一种影响全球 1%至 4%人口的慢性黏膜免疫介导性疾病。据报道，恶性病变的发展，但仅影响少数患者。我们的研究目的是评估窄带成像（NBI）在 OLP 患者中的诊断潜力；重点是识别新发病变中的高级别异型增生/癌。
方法
对 56 例经组织病理学诊断为 OLP 且出现新发病变且对药物治疗无反应的患者进行前瞻性评估。所有病变均通过高清（HD）白光（WL）和 HD-NBI 内镜进行评估。无论在 HD-WL 和 HD-NBI 下的外观如何，所有患者均进行活检。如果存在高级别异型增生或癌，则组织学定义为“阳性”。
结果
5 个病变（9%）被诊断为高级别异型增生/癌。在这种情况下，HD-NBI 的整体诊断潜力最佳，其灵敏度为 100%（95%CI，48-100），特异性为 96%（95%CI，86-99），阴性预测值为 100%（95%CI，不可计算），阳性预测值为 71%（95%CI，39-91），准确率为 96%（95%CI，88-100）。
结论
尽管 OLP 存在弥漫性炎症模式，但 NBI 提高了诊断准确性和检测高级别异型增生/癌的能力。
证据等级
4 Laryngoscope, 131:E1156-E1161, 2021.
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