使用窄带成像技术的新型IPCL分类用于口腔潜在恶性疾病恶性转化的早期检测

New IPCL Classification Using NBI for Early Detection of OPMDs Malignant Transformation.

作者信息

Xu Yiming, Zhang Tianyu, Liu Dan, Qiu Xuemei, Hou Feifei, Wang Jiongke, Luo Xiaobo, Dan Hongxia, Zhou Yu, Zeng Xing, Jiang Lu, Chen Qianming

机构信息

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.

Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.

出版信息

Oral Dis. 2025 Apr;31(4):1198-1205. doi: 10.1111/odi.15200. Epub 2024 Nov 25.

DOI:10.1111/odi.15200

PMID:39587810

Abstract

OBJECTIVES

Introduce a new intrapapillary capillary loop (IPCL) classification using narrow-band imaging (NBI) to diagnose early malignant transformation in oral potentially malignant disorders (OPMDs).

METHODS

In the exploratory phase, NBI images from 241 patients with OPMDs and oral squamous cell carcinoma (OSCC) were assessed for three basic IPCL features-dilation, unevenness, and tortuosity-to identify patterns associated with OPMDs malignant transformation. Chi-square analysis and logistic regression differentiated these patterns between low-risk (no/mild dysplasia) and high-risk (moderate/severe dysplasia, invasive carcinoma) lesions, establishing a new classification system. In the validation phase, the system was applied to 90 patients with histopathological results confirming diagnostic accuracy.

RESULTS

Four distinct IPCL types were identified: normal, dilated, irregular, and chaotic, with increasing odds ratios for high-risk lesions. The ROC curve had an AUC of 0.913, with irregular and chaotic types providing the best diagnostic performance, achieving sensitivities and specificities of 84.2% and 88.4%, respectively. In the validation phase, the new classification achieved an overall diagnostic accuracy of 84.4% and substantial inter-observer consistency (κ = 0.694).

CONCLUSION

The new IPCL classification effectively identifies high-risk oral lesions, enhancing the diagnostic utility of NBI for early detection of OPMDs malignant transformations.

摘要

目的

引入一种使用窄带成像（NBI）的新型乳头内毛细血管袢（IPCL）分类方法，以诊断口腔潜在恶性疾病（OPMDs）的早期恶性转化。

方法

在探索阶段，对241例OPMDs患者和口腔鳞状细胞癌（OSCC）患者的NBI图像进行评估，观察三种基本的IPCL特征——扩张、不均匀性和迂曲度，以确定与OPMDs恶性转化相关的模式。卡方分析和逻辑回归区分了低风险（无/轻度发育异常）和高风险（中度/重度发育异常、浸润性癌）病变之间的这些模式，建立了一种新的分类系统。在验证阶段，将该系统应用于90例组织病理学结果证实诊断准确性的患者。