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自体荧光引导下口腔鳞状细胞癌手术的临床经验

Clinical Experience with Autofluorescence Guided Oral Squamous Cell Carcinoma Surgery.

作者信息

Pošta Petr, Kolk Andreas, Pivovarčíková Kristýna, Liška Jan, Genčur Jiří, Moztarzadeh Omid, Micopulos Christos, Pěnkava Adam, Frolo Maria, Bissinger Oliver, Hauer Lukáš

机构信息

Department of Stomatology, University Hospital Pilsen, Faculty of Medicine, Charles University, 32300 Pilsen, Czech Republic.

Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria.

出版信息

Diagnostics (Basel). 2023 Oct 10;13(20):3161. doi: 10.3390/diagnostics13203161.

Abstract

In our study, the effect of the use of autofluorescence (Visually Enhanced Lesion Scope-VELscope) on increasing the success rate of surgical treatment in oral squamous carcinoma (OSCC) was investigated. Our hypothesis was tested on a group of 122 patients suffering from OSCC, randomized into a study and a control group enrolled in our study after meeting the inclusion criteria. The preoperative checkup via VELscope, accompanied by the marking of the range of a loss of fluorescence in the study group, was performed before the surgery. We developed a unique mucosal tattoo marking technique for this purpose. The histopathological results after surgical treatment, i.e., the margin status, were then compared. In the study group, we achieved pathological free margin (pFM) in 55 patients, pathological close margin (pCM) in 6 cases, and we encountered no cases of pathological positive margin (pPM) in the mucosal layer. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases, and pFM in 40 of all cases in the mucosal layer. This study demonstrated that preoperative autofluorescence assessment of the mucosal surroundings of OSCC increased the ability to achieve pFM resection 4.8 times in terms of lateral margins.

摘要

在我们的研究中,调查了使用自体荧光(视觉增强病变范围-VELscope)对提高口腔鳞状细胞癌(OSCC)手术治疗成功率的影响。我们的假设在一组122例OSCC患者中进行了检验,这些患者在符合纳入标准后被随机分为研究组和对照组纳入我们的研究。研究组在手术前通过VELscope进行术前检查,并对荧光缺失范围进行标记,为此我们开发了一种独特的黏膜纹身标记技术。然后比较手术治疗后的组织病理学结果,即切缘状态。在研究组中,55例患者实现了病理切缘阴性(pFM),6例为病理切缘接近(pCM),黏膜层未出现病理切缘阳性(pPM)病例。相比之下,对照组结果显示黏膜层中7例为pPM,14例为pCM,40例为pFM。本研究表明,术前对OSCC黏膜周围进行自体荧光评估可使实现pFM切除的能力在侧切缘方面提高4.8倍。

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