Autofluorescence Endoscopy in the Diagnosis of Early Laryngeal Cancer and Its Precursor Lesions

Malzahn, K; Dreyer, Thomas; Glanz, H.; Arens, Christoph

doi:10.1097/00005537-200203000-00015

Cited by 88 publications

(74 citation statements)

References 16 publications

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“…In 2006, Arens and his colleagues (130) affirmed that it is not possible to detect the responsible endogenous fluorophore from the remitted autofluorescence light because it is a summation spectrum, and in thickened precancerous and cancerous mucosa (>300 µm) the light beam is not able to penetrate. On the contrary, Wang et al (116,126,128,130,238) image the high grade of heterogeneity found in our study, that could be linked the high incidence of false positive results with a still rather low Sp (80%). In fact, due to the high absorption of excitation light by haemoglobin, false positives (decreased autofluorescence with a nonmalignant histopathology) occurred more frequently in the presence of highly vascularized lesions such as telangiectasic polyps, granulation tissue, papillomas; while they were relatively common in case of scar tissue or pronounced local inflammatory reactions of the mucosa.…”

contrasting

confidence: 91%

“…Fluorophores are present at different concentrations in healthy and neoplastic laryngeal mucosa; for example, nicotinamide adenine dinucleotide (NADH) predominates within neoplastic cells in its dehydrogenated nonfluorescent form (113,114). Several fluorophores are normally found within laryngeal mucosa including prophyrins, elastin, collagen, and NADH (115,116). Because each fluorophore has a specific wavelength at which its electrons are maximally excited, it is possible to target specific fluorophores, such as NADH, using an illuminating light of a single wavelength (monochromatic).…”

Section: Autofluorescencementioning

confidence: 99%

“…As a result, epithelial hyperkeratosis may hide neoplastic changes within the basal mucosal layer (130). Second, granulation tissue and teleangiectasia produce a similar reduction in bright-green fluorescence, attributed to the absorbative properties of a heme molecule, which makes them indistinguishable from neoplasia by autofluorescence (116). Third, scar tissue, necrosis, and inflammation can unpredictably alter mucosal fluorescence (116,126,129).…”

Section: Autofluorescencementioning

confidence: 99%

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Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Abstract.Background: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions that are macroscopically challenging to identify and distinguish from initial cancerous foci. Since the treatment of laryngeal cancer and its precursor lesions has a great impact on important laryngeal basic functions, early detection and preoperative assessment are important for a curative and function-preserving therapy. Nowadays, despite the high number of more advanced diagnostic techniques and methods, unfortunately, it is not uncommon for different clinicians to use different nomenclature or to identify different stage for the same laryngeal lesion. From these observations, it is obvious that an instrument offering the possibility to detect precancerous lesions, early cancerous lesions, and satellite foci or second primaries would be the key to improving management and outcome in laryngeal patients. Object. Different modalities of diagnostic techniques of laryngeal lesions exist. Rather than difference between benign and obvious malignant diseases, more difficult is to detect the presence of precancerous epithelial alterations. Not all tests achieve the same diagnostic accuracy, hence this meta-analysis of literature aimed to synthesize the validity of each single diagnostic technique in identifying and staging laryngeal disease. Methods: A systematic review of literature was led searching for articles mentioning the following terms including their various combinations to maximize the yield: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward, reporting a minumun series of 10 patients each study, declaring sensitivity and specificity of each diagnostic system. Results: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a quality score of ≥ 6 (good), 16 presented a score between 4 and 5 (fair). While objections can be raised about the pooling of different diagnostic procedures under the same group and the high level of heterogeneity in the meta-analyses, the inclusion of over 4400 laryngeal lesions makes the results fairly robust. Conclusions: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and successfully manage patients with voice disorders can be found herein. With these data, clinicians can riskstratify patients and select proper examination modalities in order to provide appropriate care. Moreover, study limitations, together with p...

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contrasting

confidence: 91%

Section: Autofluorescencementioning

confidence: 99%

Section: Autofluorescencementioning

confidence: 99%

See 1 more Smart Citation

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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show abstract

“…In 90% of cases carcinomas develop from precancerous epithelial lesions [8]. Prompt treatment after an early diagnosis is capable to prevent the development of an invasive neoplasm and the consequent recourse to more invasive laryngeal surgery [3,9].…”

Section: Discussionmentioning

confidence: 99%

Management of laryngeal precancerous lesions

et al. 2012

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“…Several methods were introduced to improve the accuracy of sampling during microlaryngoscopy. Among these technologies, "optical" biopsy (Kothe et al, 2005), rigid endoscopy (Kawaida et al, 1998), contact endoscopy (Andrea et al, 1995a;Andrea et al, 1995b;Arens et al, 2003;Carriero et al, 2000;Cikojevic et al, 2008;Wardrop et al, 2000), autofluorescence endoscopy (Delank et al, 2000;Gillenwater et al, 1998;Harries et al, 1995;Malzahn et al, 2002), aminolevulinic acidinduced fluorescence (Arens et al, 2007;Csanady et al, 2004;Gillenwater et al, 1998) and optical coherence tomography (OCT) (Armstrong et al, 2006;Lüerßen et al, 2006;Wong et al, 2005) should be noted. Except for the latter method, all technologies mentioned mainly visualize macroscopically suspect lesions of the larynx.…”

Section: Introductionmentioning

confidence: 99%