TY - JOUR
T1 - Confocal laser endomicroscopy in the detection of head and neck precancerous lesions
AU - Nathan, Cherie Ann O.
AU - Kaskas, Nadine M.
AU - Ma, Xiaohui
AU - Chaudhery, Shubnum
AU - Lian, Timothy
AU - Moore-Medlin, Tara
AU - Shi, Runhua
AU - Mehta, Vikas
N1 - Publisher Copyright:
© 2014 American Academy of Otolaryngology - Head and Neck Surgery Foundation.
PY - 2014/7/27
Y1 - 2014/7/27
N2 - Objective. This study aimed to determine the feasibility of using probe-based confocal laser endomicroscopy (pCLE) in the diagnostic differentiation of non-neoplastic lesions from precancerous and cancerous lesions of head and neck patients.Study Design. Diagnostic test evaluation.Setting. Louisiana State University Health Shreveport.Subjects and Methods. Intravenous injection of fluorescein was given to patients with precancerous and cancerous head and neck lesions (n = 21) followed by the use of a 1.8- mm GastroFlex probe in the oral cavity with subsequent biopsies of selected areas. Probe-based confocal laser endomicroscopy images were compared to histologic evaluation of visualized sites using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).Results. The dorsal surface of the tongue was not well visualized. The remaining nonkeratinized subsites, including the buccal mucosa, floor of mouth, and ventral tongue, were well visualized. Diagnoses based on pCLE images correlated well with the gold standard diagnoses based on tissue histology. The overall sensitivity for diagnosis of dysplasia versus nondysplasia was 80.0% (95% confidence interval [CI], 62.0-98.0), specificity and PPV were 100%, and the NPV was 80.0% (95% CI, 60.0-100.0). The overall specificity, sensitivity, PPV, and NPV for pCLE diagnosis of carcinoma versus nondysplasia were 100%. The overall sensitivity for diagnosis of carcinoma versus dysplasia was 85.7% (95% CI, 73.0-99.0), specificity and PPV were 100%, and the NPV was 80.0% (95% CI, 60.0-100.0).Conclusion. The pCLE is a promising method for differentiating between nondysplastic, precancerous, and cancerous lesions of the head and neck.
AB - Objective. This study aimed to determine the feasibility of using probe-based confocal laser endomicroscopy (pCLE) in the diagnostic differentiation of non-neoplastic lesions from precancerous and cancerous lesions of head and neck patients.Study Design. Diagnostic test evaluation.Setting. Louisiana State University Health Shreveport.Subjects and Methods. Intravenous injection of fluorescein was given to patients with precancerous and cancerous head and neck lesions (n = 21) followed by the use of a 1.8- mm GastroFlex probe in the oral cavity with subsequent biopsies of selected areas. Probe-based confocal laser endomicroscopy images were compared to histologic evaluation of visualized sites using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).Results. The dorsal surface of the tongue was not well visualized. The remaining nonkeratinized subsites, including the buccal mucosa, floor of mouth, and ventral tongue, were well visualized. Diagnoses based on pCLE images correlated well with the gold standard diagnoses based on tissue histology. The overall sensitivity for diagnosis of dysplasia versus nondysplasia was 80.0% (95% confidence interval [CI], 62.0-98.0), specificity and PPV were 100%, and the NPV was 80.0% (95% CI, 60.0-100.0). The overall specificity, sensitivity, PPV, and NPV for pCLE diagnosis of carcinoma versus nondysplasia were 100%. The overall sensitivity for diagnosis of carcinoma versus dysplasia was 85.7% (95% CI, 73.0-99.0), specificity and PPV were 100%, and the NPV was 80.0% (95% CI, 60.0-100.0).Conclusion. The pCLE is a promising method for differentiating between nondysplastic, precancerous, and cancerous lesions of the head and neck.
KW - CellVizio
KW - GastroFlex
KW - HNSCC
KW - optical biopsy
KW - pCLE
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U2 - 10.1177/0194599814528660
DO - 10.1177/0194599814528660
M3 - Article
C2 - 24699456
AN - SCOPUS:84930722359
SN - 0194-5998
VL - 151
SP - 73
EP - 80
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 1
ER -
