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检查咽喉部大小不超过 5 毫米的微小浅表病变。

Examination of micro-superficial lesions of up to 5 mm in size in the pharyngolaryngeal region.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.

Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Japan.

出版信息

J Laryngol Otol. 2023 Jul;137(7):749-756. doi: 10.1017/S0022215122001761. Epub 2022 Aug 2.

Abstract

OBJECTIVE

For low-grade intraepithelial neoplasia cases, pharyngolaryngeal lesions equal to or less than 5 mm in size do not generally progress to invasive carcinoma. However, micro-superficial lesions equal to or less than 5 mm that showed rapid growth have been recently encountered. This study aimed to identify the characteristics of preferential progression of lesions equal to or less than 5 mm in size.

METHOD

Gross findings, endoscopic findings and pathological results of 55 lesions measuring equal to or less than 5 mm in diameter were retrospectively reviewed to identify factors that distinguish squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions.

RESULTS

The overall sensitivity, specificity, accuracy, and positive and negative predictive value of background colouration and intrapapillary capillary loop pattern in differentiation of squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions were all 100 per cent.

CONCLUSION

Diagnosis based on background colouration and the intrapapillary capillary loop pattern on narrow-band imaging facilitates the pathological examination of lesions measuring equal to or less than 5 mm.

摘要

目的

对于低级别上皮内瘤变病例,大小等于或小于 5 毫米的咽-喉病变一般不会进展为浸润性癌。然而,最近遇到了一些大小等于或小于 5 毫米的微浅表病变,这些病变生长迅速。本研究旨在确定大小等于或小于 5 毫米的病变优先进展的特征。

方法

回顾性分析了 55 个直径等于或小于 5 毫米的病变的大体检查、内镜检查和病理结果,以确定区分鳞状细胞癌或高级别上皮内瘤变与低级别上皮内瘤变或非典型病变的因素。

结果

在区分鳞状细胞癌或高级别上皮内瘤变与低级别上皮内瘤变或非典型病变方面,背景着色和黏膜内毛细血管袢模式的总体敏感性、特异性、准确性、阳性预测值和阴性预测值均为 100%。

结论

基于窄带成像的背景着色和黏膜内毛细血管袢模式的诊断有助于对大小等于或小于 5 毫米的病变进行病理检查。

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