Debnath Asim, Choudhury Mrinmoy M, Sarma Mridul K, Sharma Moitrayee, Missong Ajit K, Deka Muktanjalee
Department of Head and Neck Oncology, State Cancer Institute, Guwahati Medical College, Assam, India.
Department of Oncopathology, State Cancer Institute, Guwahati Medical College, Assam, India.
J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2036-S2039. doi: 10.4103/jpbs.jpbs_1289_23. Epub 2024 Apr 24.
As per Globocan 2012, every year the incidence of head and neck cancer is 683235/1000000 with a mortality of around 375665/1000000 thus being the sixth cause of cancer death throughout the world. Head and neck cancer includes cancer of the nasopharynx, oropharynx, hypopharynx, larynx, and oral cavity. Early diagnosis of head and neck cancer is very challenging, hence detecting mucosal lesions at an early stage decreases mortality thereby improving overall survival, disease-free survival, and quality of life. Out of different diagnostic modalities, narrow-band imaging (NBI) combined with endoscopic techniques can provide a promising diagnostic tool in detecting early lesions of head and neck cancer. Numerous studies have shown that Ki-67 is a good prognostic marker in oral cancers. Our study aims to evaluate the diagnostic accuracy of NBI and combine the Ki-67 index to diagnose head and neck cancer.
All patients were first examined under white light and then under NBI endoscopy, and a biopsy was obtained from suspected lesions and sent for histopathological examination (HPE) and Ki-67 index.
Eighty patients were examined out of which, 68 patients having lesions in the oral cavity, oropharynx, larynx, and hypopharynx were examined. The rate of detecting cancerous lesion by white light and NBI were respectively 92% and 100% for oral cavity lesions, 69% and 100% for oropharyngeal lesions, 38% and 100% for hypopharyngeal lesions, and 37% and 100% for laryngeal carcinoma. However, we have found no significant difference in detecting T2-T4 tumors. Hence, we concluded that NBI mode can be a significantly better diagnostic tool than white light mode in detecting early mucosal cancer in head and neck cancer.
We have concluded that NBI combined with Ki-67 estimation is a very promising tool that helps in the early diagnosis of mucosal lesions in head and and neck cancer.
根据《2012年全球癌症统计报告》，每年头颈癌的发病率为683235/1000000，死亡率约为375665/1000000，是全球第六大致癌死亡原因。头颈癌包括鼻咽癌、口咽癌、下咽癌、喉癌和口腔癌。头颈癌的早期诊断极具挑战性，因此早期检测黏膜病变可降低死亡率，从而提高总生存率、无病生存率和生活质量。在不同的诊断方式中，窄带成像（NBI）结合内镜技术可为检测头颈癌早期病变提供一种有前景的诊断工具。众多研究表明，Ki-67是口腔癌的一个良好预后标志物。我们的研究旨在评估NBI的诊断准确性，并结合Ki-67指数来诊断头颈癌。
所有患者首先在白光下进行检查，然后进行NBI内镜检查，从疑似病变处获取活检组织并送去进行组织病理学检查（HPE）和Ki-67指数检测。
共检查了80例患者，其中对68例口腔、口咽、喉和下咽有病变的患者进行了检查。白光和NBI检测口腔病变癌性病变的率分别为92%和100%，口咽病变为69%和100%，下咽病变为38%和100%，喉癌为37%和100%。然而，我们发现在检测T2 - T4期肿瘤方面没有显著差异。因此，我们得出结论，在检测头颈癌早期黏膜癌方面，NBI模式可能是比白光模式显著更好的诊断工具。
我们得出结论，NBI结合Ki-67评估是一种非常有前景的工具，有助于早期诊断头颈癌的黏膜病变。
