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Objectives: To determine the advantage of autofluorescent endoscopy for the identification of laryngeal cancer. Study Design: This is a prospective, multicenter clinical study. We investigated whether autofluorescent endoscopy using the Lung Imaging Fluorescent Endoscopy (LIFE)-Lung System (Xillix, Olympus) is capable of identifying early cancer of the larynx, especially in comparison with conventional white-light endoscopy and microscopic laryngoscopy. Benign lesions as well as microinvasive and invasive squamous cell carcinoma of the larynx were investigated. For logistic reasons and because of the pilot character of this study, the number of patients was limited. Methods: Sixteen patients having 24 laryngeal lesions of both benign or malignant character were subsequently examined by autofluorescent endoscopy, white-light endoscopy, and microscopic laryngoscopy. Based on optical appearance, and for each method separately, the lesions were classified as malignant or not. The visual results were documented and histologically verified. Results: The sensitivity of autofluorescent endoscopy for laryngeal cancer detection was more than 90% and therefore higher than that of white-light endoscopy and microscopic laryngoscopy. However, as far as laryngeal cancer is concerned, the specificity of autofluorescent endoscopy was very low. Many of the false-positive results were due to inflammation, hypervascularization, and edema. Conclusion: Autofluorescent endoscopy is advantageous only in the hands of an experienced ENT specialist. Although it does not replace the combination of white-light endoscopy and a critical evaluation of the clinical symptoms of the individual disease, it can profitably complement them. Autofluorescent endoscopy can help in determining whether microscopic laryngoscopy performed with general anesthesia should be recommended urgently to the patient. Microscopic laryngoscopy remains the best method for the identification of malignant lesions, if it is combined with obtaining taking multiple biopsy specimens. Confirmation of the results of this pilot study with a larger series of patients is desirable.

Pneumologie 53 (1999) W. Marek et al. 584Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages. Pneumologie 53 (1999) W. Marek et al. 588Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.Proben befand sich zu wenig repräsentatives Material für die Befundung (0) (Tab. 1). Zytometrische Befundung im Vergleich zur histogenetischen TumorklassifikationDer Verdacht auf das Vorliegen eines broncho-pulmonalen Tumors konnte histologisch oder zytologisch bei 108 der 142 untersuchten Patienten in der Enddiagnose gesichert werden (Tab. 2). Unter den Tumoren waren kleinzellige Karzinome in 26 % der Tumorfälle vertreten, die davon untersuchten Präpa-rate waren alle zytometrisch auffällig. Unter den nicht-kleinzelligen Tumoren waren Plattenepithelkarzinome mit 23 %, Adenokarzinome mit 34 % und großzellige Karzinome in 8 % vertreten.Enddiagnose als "Goldstandard"Der Vergleich mit der abschließenden Enddiagnose aus sämt-lichen Untersuchungsergebnissen als "Goldstandard", zeigte

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