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Gaiffe O, Mahdjoub J, Ramasso E, Mauvais O, Lihoreau T, Pazart L, Wacogne B, Tavernier L. Discrimination of vocal folds lesions by multiclass classification using autofluorescence spectroscopy: An ex vivo study. Head Neck 2024; 46:1136-1145. [PMID: 38299429 DOI: 10.1002/hed.27668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Autofluorescence spectroscopy is effective for noninvasive detection but underutilized in tissue with various pathology analyses. This study evaluates whether AFS can be used to discriminate between different types of laryngeal lesions in view of assisting in vocal fold surgery and preoperative investigations. METHODS A total of 1308 spectra were recorded from 29 vocal fold samples obtained from 23 patients. Multiclass analysis was performed on the spectral data, categorizing lesions into normal, benign, dysplastic, or carcinoma. RESULTS Through an appropriate selection of spectral components and a cascading classification approach based on artificial neural networks, a classification rate of 97% was achieved for each lesion class, compared to 52% using autofluorescence intensity. CONCLUSIONS The ex vivo study demonstrates the effectiveness of AFS combined with multivariate analysis for accurate classification of vocal fold lesions. Comprehensive analysis of spectral data significantly improves classification accuracy, such as distinguishing malignant from precancerous or benign lesions.
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Affiliation(s)
- Olivier Gaiffe
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie et Thérapeutiques, EA4662, Université de Franche-Comté, Besançon, France
| | - Joackim Mahdjoub
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
| | - Emmanuel Ramasso
- Institut FEMTO-ST UMR61742, Université de Franche-Comté, ENSMM, CNRS, Besançon, France
| | - Olivier Mauvais
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
| | | | | | - Bruno Wacogne
- Institut FEMTO-ST UMR61742, Université de Franche-Comté, ENSMM, CNRS, Besançon, France
- Inserm CIC 1431, CHU Besançon, Besançon, France
| | - Laurent Tavernier
- Department of Otolaryngology - Head and Neck Surgery, CHU de Besançon, Besançon, France
- Laboratoire de Nanomédecine, Imagerie et Thérapeutiques, EA4662, Université de Franche-Comté, Besançon, France
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Staníková L, Kántor P, Fedorová K, Zeleník K, Komínek P. Clinical significance of type IV vascularization of laryngeal lesions according to the Ni classification. Front Oncol 2024; 14:1222827. [PMID: 38333687 PMCID: PMC10851150 DOI: 10.3389/fonc.2024.1222827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Background Scattered, small, dot-like intraepithelial papillary capillary loops (IPCLs) represent type IV epithelial vascularization according to "Ni classification" and are considered to be nonmalignant. According to the European Laryngological Society classification, these loops are malignant vascular changes. This contradiction has high clinical importance; therefore, clarification of the clinical significance of type IV vascularization according to the Ni classification is needed. Methods The study was performed between June 2015 and December 2022. All recruited patients (n = 434) were symptomatic, with macroscopic laryngeal lesions (n = 674). Patients were investigated using the enhanced endoscopic methods of narrow band imaging (NBI) and the Storz Professional Image Enhancement System (IMAGE1 S). The microvascular patterns in the lesions were categorized according to Ni classification from 2011 and all lesions were examined histologically. Results A total of 674 lesions (434 patients) were investigated using flexible NBI endoscopy and IMAGE1 S endoscopy. Type IV vascularization was recognized in 293/674 (43.5%) lesions. Among these 293 lesions, 178 (60.7%) were benign (chronic laryngitis, hyperplasia, hyperkeratosis, polyps, cysts, granulomas, Reinkeho oedema and recurrent respiratory papillomatosis); 9 (3.1%) were squamous cell carcinoma; 61 (20.8%) were mildly dysplastic, 29 (9.9%) were moderately dysplastic, 14 (4.8%) were severe dysplastic and 2 (0.7%) were carcinoma in situ. The ability to recognize histologically benign lesions in group of nonmalignant vascular pattern according to Ni (vascularization type I-IV) and distinguish them from precancers and malignancies was with accuracy 75.5%, sensitivity 54.4%, specificity 94.4%, positive predictive value 89.6% and negative predictive value 69.9%. Conclusion Laryngeal lesions with type IV vascularization as defined by Ni present various histological findings, including precancerous and malignant lesions. Patients with type IV vascularization must be followed carefully and, in case of progression mucosal lesion microlaryngoscopy and excision are indicated.
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Affiliation(s)
- Lucia Staníková
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Peter Kántor
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Katarína Fedorová
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czechia
| | - Karol Zeleník
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Pavel Komínek
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czechia
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
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Syba J, Trnkova K, Dostalova L, Votava M, Lukesova E, Novak S, Kana M, Tesarova M, Zabrodsky M, Plzak J, Lukes P. Comparison of narrow-band imaging with autofluorescence imaging for endoscopic detection of squamous cell carcinoma of the tonsil. Eur Arch Otorhinolaryngol 2023; 280:5073-5080. [PMID: 37464156 PMCID: PMC10562293 DOI: 10.1007/s00405-023-08111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Early detection of mucosal neoplastic lesions is crucial for a patient's prognosis. This has led to the development of effective optical endoscopic diagnostic methods such as narrow band imaging (NBI) and autofluorescence (AFI). Independent of each other, both of these methods were proven useful in the detection of mucosal neoplasias. There are limited reported data comparing both methods for oropharyngeal cancer diagnostics. The aim of the study was to compare NBI and AFI endoscopic visualization of signs in identifying tonsillar squamous cell carcinoma (SCC) and assessing its extent and to determine whether the score was related to the evaluator's experience. METHODS Patients with tonsillar SCC underwent endoscopic pharyngeal examination using NBI and AFI. Fiftyseven video sequences of examinations of lesions proven to be SCC were evaluated by three reviewers. The accuracy of determination of lesion extent and visualization of its endoscopic signs of malignancy were evaluated. RESULTS Endoscopic visualization of tumour spread was significantly better using AFI than NBI (p = 0.0003). No significant difference was found between NBI and AFI in the visualization of endoscopic malignancy determining signs (p = 0.1405). No significant difference was found among the three reviewers in the visualization of tumour spread and for identifying malignancy-determining signs in NBI endoscopy or AFI endoscopy. CONCLUSIONS The results show that AFI obtained better results for assessing the extent of tonsillar cancers than NBI. Both methods were proven to be equal in the visualization of endoscopic malignancy-determining signs. Both are useful even for less experienced evaluators.
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Affiliation(s)
- J. Syba
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
- Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - K. Trnkova
- Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - L. Dostalova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - M. Votava
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - E. Lukesova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - S. Novak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - M. Kana
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - M. Tesarova
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - M. Zabrodsky
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - J. Plzak
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - P. Lukes
- Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
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Zhang YF, Shen YJ, Huang Q, Wu CP, Zhou L, Ren HL. Predicting survival of advanced laryngeal squamous cell carcinoma: comparison of machine learning models and Cox regression models. Sci Rep 2023; 13:18498. [PMID: 37898687 PMCID: PMC10613248 DOI: 10.1038/s41598-023-45831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/24/2023] [Indexed: 10/30/2023] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) is a common tumor type. High recurrence rates remain an important factor affecting the survival and quality of life of advanced LSCC patients. We aimed to build a new nomogram and a random survival forest model using machine learning to predict the risk of LSCC progress. The study included 671 patients with AJCC stages III-IV LSCC. To develop a prognostic model, Cox regression analyses were used to assess the relationship between clinic-pathologic factors and disease-free survival (DFS). RSF analysis was also used to predict the DFS of LSCC patients. The ROC curve revealed that the Cox model exhibited good sensitivity and specificity in predicting DFS in the training and validation cohorts (1 year, validation AUC = 0.679, training AUC = 0.693; 3 years, validation AUC = 0.716, training AUC = 0.655; 5 years, validation AUC = 0.717, training AUC = 0.659). Random survival forest analysis showed that N stage, clinical stage, and postoperative chemoradiotherapy were prognostically significant variables associated with survival. The random forest model exhibited better prediction ability than the Cox regression model in the training cohort; however, the two models showed similar prediction ability in the validation cohort.
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Affiliation(s)
- Yi-Fan Zhang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Yu-Jie Shen
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Qiang Huang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Chun-Ping Wu
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| | - Liang Zhou
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| | - Heng-Lei Ren
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
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Esmaeili N, Davaris N, Boese A, Illanes A, Navab N, Friebe M, Arens C. Contact Endoscopy - Narrow Band Imaging (CE-NBI) data set for laryngeal lesion assessment. Sci Data 2023; 10:733. [PMID: 37865668 PMCID: PMC10590430 DOI: 10.1038/s41597-023-02629-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/11/2023] [Indexed: 10/23/2023] Open
Abstract
The endoscopic examination of subepithelial vascular patterns within the vocal fold is crucial for clinicians seeking to distinguish between benign lesions and laryngeal cancer. Among innovative techniques, Contact Endoscopy combined with Narrow Band Imaging (CE-NBI) offers real-time visualization of these vascular structures. Despite the advent of CE-NBI, concerns have arisen regarding the subjective interpretation of its images. As a result, several computer-based solutions have been developed to address this issue. This study introduces the CE-NBI data set, the first publicly accessible data set that features enhanced and magnified visualizations of subepithelial blood vessels within the vocal fold. This data set encompasses 11144 images from 210 adult patients with pathological vocal fold conditions, where CE-NBI images are annotated using three distinct label categories. The data set has proven invaluable for numerous clinical assessments geared toward diagnosing laryngeal cancer using Optical Biopsy. Furthermore, given its versatility for various image analysis tasks, we have devised and implemented diverse image classification scenarios using Machine Learning (ML) approaches to address critical clinical challenges in assessing laryngeal lesions.
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Affiliation(s)
- Nazila Esmaeili
- Department of Otorhinolaryngology, Head and Neck Surgery, Justus Liebig University of Giessen, 35392, Giessen, Germany.
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, 85748, Munich, Germany.
- SURAG Medical GmbH, 04103, Leipzig, Germany.
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen University Hospital, 35392, Giessen, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120, Magdeburg, Germany
| | - Axel Boese
- INKA-Innovation Laboratory for Image Guided Therapy, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
| | | | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, 85748, Munich, Germany
| | - Michael Friebe
- INKA-Innovation Laboratory for Image Guided Therapy, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120, Magdeburg, Germany
- Department of Biocybernetics and Biomedical Engineering, AGH University Kraków, 30-059, Kraków, Poland
- CIBE - Center for Innovation, Business Development & Entrepreneurship, FOM University of Applied Sciences, 45141, Essen, Germany
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen University Hospital, 35392, Giessen, Germany
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Li Y, Gu W, Yue H, Lei G, Guo W, Wen Y, Tang H, Luo X, Tu W, Ye J, Hong R, Cai Q, Gu Q, Liu T, Miao B, Wang R, Ren J, Lei W. Real-time detection of laryngopharyngeal cancer using an artificial intelligence-assisted system with multimodal data. J Transl Med 2023; 21:698. [PMID: 37805551 PMCID: PMC10559609 DOI: 10.1186/s12967-023-04572-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/23/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Laryngopharyngeal cancer (LPC) includes laryngeal and hypopharyngeal cancer, whose early diagnosis can significantly improve the prognosis and quality of life of patients. Pathological biopsy of suspicious cancerous tissue under the guidance of laryngoscopy is the gold standard for diagnosing LPC. However, this subjective examination largely depends on the skills and experience of laryngologists, which increases the possibility of missed diagnoses and repeated unnecessary biopsies. We aimed to develop and validate a deep convolutional neural network-based Laryngopharyngeal Artificial Intelligence Diagnostic System (LPAIDS) for real-time automatically identifying LPC in both laryngoscopy white-light imaging (WLI) and narrow-band imaging (NBI) images to improve the diagnostic accuracy of LPC by reducing diagnostic variation among on-expert laryngologists. METHODS All 31,543 laryngoscopic images from 2382 patients were categorised into training, verification, and test sets to develop, validate, and internal test LPAIDS. Another 25,063 images from five other hospitals were used as external tests. Overall, 551 videos were used to evaluate the real-time performance of the system, and 200 randomly selected videos were used to compare the diagnostic performance of the LPAIDS with that of laryngologists. Two deep-learning models using either WLI (model W) or NBI (model N) images were constructed to compare with LPAIDS. RESULTS LPAIDS had a higher diagnostic performance than models W and N, with accuracies of 0·956 and 0·949 in the internal image and video tests, respectively. The robustness and stability of LPAIDS were validated in external sets with the area under the receiver operating characteristic curve values of 0·965-0·987. In the laryngologist-machine competition, LPAIDS achieved an accuracy of 0·940, which was comparable to expert laryngologists and outperformed other laryngologists with varying qualifications. CONCLUSIONS LPAIDS provided high accuracy and stability in detecting LPC in real-time, which showed great potential for using LPAIDS to improve the diagnostic accuracy of LPC by reducing diagnostic variation among on-expert laryngologists.
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Affiliation(s)
- Yun Li
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Wenxin Gu
- School of Computer Science and Engineering, Guangdong Province Key Lab of Computational Science, Sun Yat-Sen University, Guangzhou, 510006, Guangdong, China
| | - Huijun Yue
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Guoqing Lei
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Wenbin Guo
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Yihui Wen
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Haocheng Tang
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Luo
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wenjuan Tu
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jin Ye
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ruomei Hong
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qian Cai
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qingyu Gu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Tianrun Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Beiping Miao
- Department of Otolaryngology-Head and Neck Surgery, Shenzhen Secondary Hospital and First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Ruxin Wang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jiangtao Ren
- School of Computer Science and Engineering, Guangdong Province Key Lab of Computational Science, Sun Yat-Sen University, Guangzhou, 510006, Guangdong, China.
| | - Wenbin Lei
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
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Klimza H, Witkiewicz J, Jackowska J, Wierzbicka M. Difficult glottis: Diagnostic dilemma in viewof the clinical presentation. OTOLARYNGOLOGIA POLSKA 2023; 77:53-57. [PMID: 37772377 DOI: 10.5604/01.3001.0053.7263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
<br><b>Introduction:</b> The taxonomy of vocal fold lesions has been refined, and it serves as a common descriptive language for diagnosis, treatment algorithms, and reporting of outcomes. However, we observe rare cases when numerous pathologies overlap, resulting in an unclear and complicated clinical presentation of the glottis.</br> <br><b>Aim:</b> The aim of this paper is to present cases of overlapping etiopathological factors which poses a challenge when making a diagnosis and referring a patient for adequate treatment.</br> <br><b>Material and method:</b> The study presents different photographs of the glottis, including some unique and unusual images in which overlapping pathologies were captured. The photographs are accompanied by case descriptions, comments, and pathological analyses.</br> <br><b>Results:</b> Four selected photographs showed a bunch of exophytic growth lesions with foci of whitish plaques, covered by yellowish crusts, with thinned, reddened vocal folds presenting foci of leukoplakia. The study discussed possible causes of vocal folds edema, diffuse erythema, presence of crusts or exudate, whitish debris/plaques or development of leukoplakia, non-neoplastic ulceration, as well as injected and reddened mucous membrane. Chronic infectious laryngitis, idiopathic ulcerative laryngitis, and drug-induced laryngitis were also mentioned. The study also raised the issues concerning diabetics and patients treated with inhaled corticosteroids, including candidiasis and primary aspergillosis of the larynx.</br> <br><b>Conclusions:</b> To conclude, everyday clinical practice involves encountering cases of unclear onset and course, with complicated presentation of the glottis. Therefore, comprehensive history-taking and thorough investigation of systemic causes are of immense importance. Recommended management includes conducting the most meticulous differential diagnosis, implementing treatment for the most likely cause, and, whenever possible, refraining from biopsy in order to avoid permanent damage to vocal cords.</br>.
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Affiliation(s)
- Hanna Klimza
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Medical University of Karol Marcinkowski, Poznan, Poland
| | - Joanna Witkiewicz
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Medical University of Karol Marcinkowski, Poznan, Poland
| | - Joanna Jackowska
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Medical University of Karol Marcinkowski, Poznan, Poland
| | - Małgorzata Wierzbicka
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Medical University of Karol Marcinkowski, Poznan, Poland
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8
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Deva FAL. Narrow Band Imaging Technology: Role in the Detection of Recurrent Laryngeal and Hypopharyngeal Cancers Post-radiotherapy. Indian J Otolaryngol Head Neck Surg 2023; 75:753-759. [PMID: 37275073 PMCID: PMC10235265 DOI: 10.1007/s12070-022-03457-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
To assess the diagnostic accuracy of NBI endoscopy for the diagnosis of early recurrent laryngeal and hypopharyngeal cancers after radiotherapy. The study was conducted over a period of two and a half years from June 2019 to February 2022 and included 123 post-RT patients with laryngeal and hypopharyngeal cancers. The patients were planned for endoscopy with white light and narrow-band imaging. The biopsy was carried out in NBI suspected lesions and sent for histopathological examination. The pathologist was blinded to the outcome of NBI and WLE results to eliminate observer bias. The age group most commonly affected in our study was 40-50 years. Out of the 123 patients, 106 were males and 17 were females. The overall Sensitivity, Specificity, Positive predictive value and Negative predictive value of NBI for malignant lesions were 90.6%, 99%, 95.2% and 98% respectively. NBI Technology is a first-rate diagnostic tool that can help in diagnosing early recurrent cancer lesions, especially after RT, in which the recurrence is otherwise difficult to differentiate from post-radiotherapy oedema. This technology can significantly reduce the rates of failure to detect cancers in early stages.
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9
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Gong XY, Chen HB, Lu ZY, Zhu C, Chen DS, Chen X. Prospective role of liquid biopsy for early screening in laryngeal cancer. Invest New Drugs 2023:10.1007/s10637-023-01365-4. [PMID: 37129839 DOI: 10.1007/s10637-023-01365-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Xiao-Yang Gong
- Department of Otorhinolaryngology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Hai-Bing Chen
- Department of Otorhinolaryngology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Zhao-Yi Lu
- Department of Otorhinolaryngology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Chan Zhu
- Department of Otorhinolaryngology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Dong-Sheng Chen
- The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, 210002, China
| | - Xi Chen
- Department of Otorhinolaryngology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
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10
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Itamura K, Hsue VB, Barbu AM, Chen MM. Diagnostic Assessment (Imaging) and Staging of Laryngeal Cancer. Otolaryngol Clin North Am 2023; 56:215-231. [PMID: 37030936 DOI: 10.1016/j.otc.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
Diagnosis of larynx cancer relies on a detailed history and physical and objective assessment with endoscopy and imaging. Endoscopy is needed to assess for vocal fold function that directly affects staging. Computed tomography and MRI can be used to assess for tumor extent in relation to intra- and extra-laryngeal structures, especially paraglottic and pre-epiglottic space involvement as well as cartilage invasion. Accurate staging is critical for subsequent treatment decision-making regarding larynx preservation.
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Affiliation(s)
- Kyohei Itamura
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Victor B Hsue
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Anca M Barbu
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA
| | - Michelle M Chen
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, 8635 West Third Street #590W, Los Angeles, CA 90048, USA; Department of Otolaryngology-Head and Neck Surgery, Stanford University, 900 Blake Wilbur Drive Rm W3045, Stanford, CA 94305, USA.
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Yang H, Xiao M, Zheng W, Wang J, Lin Q, Lin X, Zhou J, Yang A, Guo Z, Han F. Ultrasound-guided core needle biopsy for accessing laryngeal masses with unsatisfactory laryngoscopy and biopsy results. Am J Otolaryngol 2023; 44:103716. [PMID: 36774812 DOI: 10.1016/j.amjoto.2022.103716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Laryngoscopy and biopsy is the standard techniques to sample and diagnose laryngeal neoplasms, but not all patients with laryngeal neoplasm are eligible for biopsy via laryngoscopy (e.g., submucosal neoplasms). PURPOSE This study was conducted to evaluate the feasibility and diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) for submucosal laryngeal neoplasms with unsatisfactory laryngoscopy and biopsy results. METHODS We retrospectively reviewed the medical records of 24 patients with unsatisfactory laryngoscopy and biopsy results who were referred to our center for US-CNB from January 2017 to November 2021. For all enrolled patients, we assessed consistency between the laryngoscopic biopsy, US-CNB, and final results. The final results were determined from the surgical biopsy results or clinical follow-up information (at least 3 month). Differences between biopsy techniques were compared using the Fisher's exact test. A P value less than 0.05 indicated statistical significance. RESULTS Twenty-four patients (median [range] age: 60.6 [41-76] years, 20 men) were included in our study. Among the 24 patients, 12 were eligible for laryngoscopic biopsy. In total, 24 patients underwent 26 US-CNB. Two patients underwent a repeat US-CNB for conformation of a benign histological result or due to inadequate specimen collection. The results of laryngoscopic biopsy and US-CNB were compared with the final result. The overall accuracy of US-CNB for differentiating benign from malignant lesions was 95.8 % (23/24), and this procedure had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2 %, 100 %, 100 %, and 75 %, respectively. The results of US-CNB are significantly better than those of laryngoscopic biopsy. CONCLUSIONS US-CNB is a safe, effective, and feasible technique for investigating suspicious submucosal laryngeal neoplasms and can serve as a complementary method for early and timely diagnosis of those neoplasms.
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Affiliation(s)
- Hao Yang
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Meiqin Xiao
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Wei Zheng
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Jianwei Wang
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Qingguang Lin
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Xi Lin
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Jianhua Zhou
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Ankui Yang
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Zhixing Guo
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Feng Han
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China.
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Bassani S, Lee YK, Campagnari V, Eccher A, Monzani D, Nocini R, Sacchetto L, Molteni G. From Hype To Reality: A Narrative Review on the Promising Role of Artificial Intelligence in Larynx Cancer Detection and Transoral Microsurgery. Crit Rev Oncog 2023; 28:21-24. [PMID: 37968989 DOI: 10.1615/critrevoncog.2023049134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Early larynx cancer detection plays a crucial role in improving treatment outcomes and recent studies have shown promising results in using artificial intelligence for larynx cancer detection. Artificial intelligence also has the potential to enhance transoral larynx microsurgery. This narrative review summarizes the current evidence regarding its use in larynx cancer detection and potential applications in transoral larynx microsurgery. The utilization of artificial intelligence in larynx cancer detection with white light endoscopy and narrow-band imaging helps improve diagnostic accuracy and efficiency. It can also potentially enhance transoral larynx microsurgery by aiding surgeons in real-time decision-making and minimizing the risk of complications. However, further prospective studies are warranted to validate the findings, and additional research is necessary to optimize the integration of artificial intelligence in our clinical practice.
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Affiliation(s)
- Sara Bassani
- Otolaryngology-Head and Neck Surgery Department, University of Verona, Verona, Italy
| | - Ying Ki Lee
- Head and Neck Surgery Department, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Valentina Campagnari
- Unit of Otorhinolaryngology- Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Daniele Monzani
- Otolaryngology-Head and Neck Surgery Department, University of Verona, Verona, Italy
| | - Riccardo Nocini
- Otolaryngology-Head and Neck Surgery Department, University of Verona, Verona, Italy
| | - Luca Sacchetto
- Otolaryngology-Head and Neck Surgery Department, University of Verona, Verona, Italy
| | - Gabriele Molteni
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
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Sargunaraj JJE, Mathews SS, Paul RR, Michael RC, Thomas M, Gowri M, Albert RRA. Role of Narrow Band Imaging in Laryngeal Lesions: A Prospective Study from Southern India. Indian J Otolaryngol Head Neck Surg 2022; 74:5127-5133. [PMID: 36742616 PMCID: PMC9895569 DOI: 10.1007/s12070-021-02945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
To assess the utility of Narrow Band Imaging (NBI) as a diagnostic tool in evaluating laryngeal pathology in patients presenting with hoarseness. Study design: Prospective cross sectional diagnostic study. Methods: 200 patients with voice change were recruited and laryngeal findings documented with high definition flexible endoscopy with both white light and narrow band light and the representative still images recorded for analysis. The NBI intraepithelial papillary capillary loop (IPCL) patterns was compared with the histopathology report. Of the 200 patients evaluated, 84 lesions were biopsied which included both benign and malignant lesions. The sensitivity obtained was 73.3% [54.1-87.7% with 95% CI] and the specificity was 87% [75.1-94.6% with 95% CI] for detecting malignant lesions. NBI can be considered as a useful diagnostic tool in evaluating laryngeal pathology and can be used to detect early premalignant and malignant lesions.
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Affiliation(s)
| | - Suma Susan Mathews
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Roshna Rose Paul
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Rajiv C. Michael
- Department of Head and Neck Surgery, Christian Medical College, Vellore, 632004 India
| | - Meera Thomas
- Department of General Pathology, Christian Medical College, Vellore, 632004 India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, 632004 India
| | - Rita Ruby A. Albert
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
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14
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Żurek M, Jasak K, Niemczyk K, Rzepakowska A. Artificial Intelligence in Laryngeal Endoscopy: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11102752. [PMID: 35628878 PMCID: PMC9144710 DOI: 10.3390/jcm11102752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/24/2022] [Accepted: 05/08/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Early diagnosis of laryngeal lesions is necessary to begin treatment of patients as soon as possible to preserve optimal organ functions. Imaging examinations are often aided by artificial intelligence (AI) to improve quality and facilitate appropriate diagnosis. The aim of this study is to investigate diagnostic utility of AI in laryngeal endoscopy. Methods: Five databases were searched for studies implementing artificial intelligence (AI) enhanced models assessing images of laryngeal lesions taken during laryngeal endoscopy. Outcomes were analyzed in terms of accuracy, sensitivity, and specificity. Results: All 11 studies included presented an overall low risk of bias. The overall accuracy of AI models was very high (from 0.806 to 0.997). The accuracy was significantly higher in studies using a larger database. The pooled sensitivity and specificity for identification of healthy laryngeal tissue were 0.91 and 0.97, respectively. The same values for differentiation between benign and malignant lesions were 0.91 and 0.94, respectively. The comparison of the effectiveness of AI models assessing narrow band imaging and white light endoscopy images revealed no statistically significant differences (p = 0.409 and 0.914). Conclusion: In assessing images of laryngeal lesions, AI demonstrates extraordinarily high accuracy, sensitivity, and specificity.
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Affiliation(s)
- Michał Żurek
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland; (K.N.); (A.R.)
- Doctoral School, Medical University of Warsaw, 61 Żwirki i Wigury Str., 02-091 Warsaw, Poland
- Correspondence: ; Tel.: +48-225992716
| | - Kamil Jasak
- Students Scientific Research Group, Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland;
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland; (K.N.); (A.R.)
| | - Anna Rzepakowska
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland; (K.N.); (A.R.)
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Esmaeili N, Sharaf E, Gomes Ataide EJ, Illanes A, Boese A, Davaris N, Arens C, Navab N, Friebe M. Deep Convolution Neural Network for Laryngeal Cancer Classification on Contact Endoscopy-Narrow Band Imaging. SENSORS 2021; 21:s21238157. [PMID: 34884166 PMCID: PMC8662427 DOI: 10.3390/s21238157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/14/2022]
Abstract
(1) Background: Contact Endoscopy (CE) and Narrow Band Imaging (NBI) are optical imaging modalities that can provide enhanced and magnified visualization of the superficial vascular networks in the laryngeal mucosa. The similarity of vascular structures between benign and malignant lesions causes a challenge in the visual assessment of CE-NBI images. The main objective of this study is to use Deep Convolutional Neural Networks (DCNN) for the automatic classification of CE-NBI images into benign and malignant groups with minimal human intervention. (2) Methods: A pretrained Res-Net50 model combined with the cut-off-layer technique was selected as the DCNN architecture. A dataset of 8181 CE-NBI images was used during the fine-tuning process in three experiments where several models were generated and validated. The accuracy, sensitivity, and specificity were calculated as the performance metrics in each validation and testing scenario. (3) Results: Out of a total of 72 trained and tested models in all experiments, Model 5 showed high performance. This model is considerably smaller than the full ResNet50 architecture and achieved the testing accuracy of 0.835 on the unseen data during the last experiment. (4) Conclusion: The proposed fine-tuned ResNet50 model showed a high performance to classify CE-NBI images into the benign and malignant groups and has the potential to be part of an assisted system for automatic laryngeal cancer detection.
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Affiliation(s)
- Nazila Esmaeili
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, 85748 Munich, Germany;
- Correspondence:
| | - Esam Sharaf
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
| | - Elmer Jeto Gomes Ataide
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
- Department of Nuclear Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
| | - Alfredo Illanes
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
| | - Axel Boese
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany;
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Giessen University Hospital, 35392 Giessen, Germany;
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University of Munich, 85748 Munich, Germany;
| | - Michael Friebe
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (E.S.); (E.J.G.A.); (A.I.); (A.B.); (M.F.)
- IDTM GmbH, 45657 Recklinghausen, Germany
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Diagnostic value of autofluorescence laryngoscope in early laryngeal carcinoma and precancerous lesions: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2021; 35:102460. [PMID: 34329763 DOI: 10.1016/j.pdpdt.2021.102460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We aim to evaluate the diagnostic value of autofluorescence laryngoscope (AFL) in early laryngeal carcinoma and precancerous lesions. aWe also assess the value of AFL in diagnosis of early laryngeal carcinoma and precancerous lesions in comparison with that of white light laryngoscope (WL). METHODS The databases consisting of PubMed, Cochrane Library, Web of science and CNKI were systematically searched to find pertinent literatures of AFL in diagnosing early laryngeal carcinoma and precancerous lesions. We made a quality evaluation of every study we included using the modified Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled sensitivities, specificities were calculated using Meta-Disc 1.4. And we estimated the summary receiver operating characteristic curves (SROC) and area under the curves (AUC). RESULTS We finally included 23 studies. The results of AFL in diagnosing early laryngeal carcinoma and precancerous lesions showed higher sensitivity of 0.91 (95%CI: 0.89-0.93; χ²=43.78, p = 0.0025) and specificity of 0.80 (95%CI: 0.77-0.82; χ²=130.64, p = 0.000), and the weighted AUC of AFL was 0.948 ± 0.013 (95%CI: 0.921-0.974) and the diagnostic accuracy (Q*) was 0.887 ± 0.018. The sensitivity and specificity of WL were 0.74 (95%CI: 0.70-0.77; χ²=52.40, p = 0.000) and 0.89 (95%CI: 0.87-0.90; χ²=299.22, p = 0.000), and the weighted AUC of WL was 0.835 ± 0.029 (95%CI: 0.777-0.892) and the diagnostic accuracy (Q*) was 0.767 ± 0.027. CONCLUSION The meta-analysis and systematic review suggested that AFL had high diagnostic value in early laryngeal carcinoma and precancerous lesions, and its diagnostic value was higher than that of WL. These results indicated that AFL can provide good guidance for the early detection of laryngeal carcinoma and precancerous lesions.
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Yu F, Lin Y, Ai MM, Tan GJ, Huang JL, Zou ZR. Knockdown of Circular RNA hsa_circ_PVT1 Inhibited Laryngeal Cancer Progression via Preventing wnt4/β-Catenin Signaling Pathway Activation. Front Cell Dev Biol 2021; 9:658115. [PMID: 34336825 PMCID: PMC8322683 DOI: 10.3389/fcell.2021.658115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/22/2021] [Indexed: 12/30/2022] Open
Abstract
Aim To explore the function and mechanism of circular has_circ_PVT1 on laryngeal cancer (LC). Methods Microarray chip was performed to screen the differential expression of circRNA. Western blot and qRT-PCR was employed to detect the protein and mRNA level. CCK-8, clone formation, cell cycle, wound healing, and Transwell assay were performed to detect the cell proliferation, migration, and invasion ability. Luciferase assay and Fish were used to confirm the relationship between circ_PVT1/CBX4 and miR-21-5p. Flow cytometry and TUNEL assay were carried out to assess the apoptosis level. Results The upregulation of circ_PVT1 was found in LC tissues and cells. Silencing of circ_PVT1 inhibited LC progression via targeting miR-21-5p and indirectly controlling CBX4. Wnt4/β-catenin signal pathway was inactivated by inhibiting the expression of circ_PVT1. Conclusion Knockdown of circ_PVT1 prevented LC progression via targeting miR-21-5p/CBX4 by inhibiting wnt4/β-catenin signal pathway, which could provide a novel therapeutic target for LC.
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Affiliation(s)
- Feng Yu
- Department of Otolaryngology Head and Neck, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Ying Lin
- Department of Otolaryngology Head and Neck, Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Mao-Mao Ai
- Department of Otolaryngology Head and Neck, Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Guo-Jie Tan
- Department of Otolaryngology Head and Neck, Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jia-Li Huang
- Department of Otolaryngology Head and Neck, Shenzhen Longhua District Central Hospital, Guangdong Medical University, Shenzhen, China
| | - Zi-Rou Zou
- Department of Otolaryngology Head and Neck, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
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Vocal Fold Leukoplakia: Which of the Classifications of White Light and Narrow Band Imaging Most Accurately Predicts Laryngeal Cancer Transformation? Proposition for a Diagnostic Algorithm. Cancers (Basel) 2021; 13:cancers13133273. [PMID: 34208811 PMCID: PMC8268866 DOI: 10.3390/cancers13133273] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 12/12/2022] Open
Abstract
The management of Vocal Fold Leukoplakia (VFL) remains problematic. There is no consensus on the indications or the timing for surgery. The objective was to select the most accurate classification for predicting low- and high-risk VFL in White Light Imaging (WLI) and Narrow Band Imaging (NBI) and to establish a diagnostic algorithm with a timely referral for treatment. A total of 259 VFL patients were included in the study; 186 lesions were classified as low-grade and 110 as high-grade dysplasia. The results of WLI acc. to the two-tier and the three-tier Chen 2019 classifications and NBI classifications: ELS, Ni 2011, and Ni 2019 with different cut-off points were compared with the pathological examination (HP). In WLI, the greatest agreement was obtained between type 3 of the three-tier classification and high-grade dysplasia (accuracy, specificity, and PPV: 80.4%, 92.0%, and 81.5%, respectively). Assessing VFL periphery in NBI, cut-off point 5 (Ni 2011 type V) demonstrated a higher accuracy, specificity, and PPV than 4 (83.1%, 93.6%, 85.5% and 77.4%, 74.9%, and 65.4%, respectively). In NBI, we observed higher accuracy, sensitivity, and PPV (84.1%, 93.0%, 85.2% vs. 80.7%, 81.3% and 71.3%, respectively) for cut-off point 5 (Ni 2019 type V and VI) in comparison to the cut-off point 4 group (type IV, V, and VI) (80.7%, 81.3%, 71.3%, respectively), and a higher kappa value (0.68 vs. 0.58) was obtained. We have shown that both the plaque image and the microvascular pattern on the leukoplakia periphery are critical in the diagnosis of high-risk VFL. The most accurate predictor of VFL malignant transformation in WLI is type 3 according to the Chen 2019 classification, while in NBI type V and VI according to the Ni 2019 classification.
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Interactive regulation of laryngeal cancer and neuroscience. Biochim Biophys Acta Rev Cancer 2021; 1876:188580. [PMID: 34129916 DOI: 10.1016/j.bbcan.2021.188580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 01/11/2023]
Abstract
Nerve fibres are distributed throughout the body along with blood and lymphatic vessels. The intrinsic morphological characteristics of nerves and the general characteristics of secretions in the tumour microenvironment provide a solid theoretical basis for exploring how neuronal tissue can influence the progression of laryngeal cancer (LC). The central nervous system (CNS) and the peripheral nervous system (PNS) jointly control many aspects of cancer and have attracted widespread attention in the study of the progression, invasion and metastasis of tumour tissue banks. Stress activates the neuroendocrine response of the human hypothalamus-pituitary-adrenal (HPA) axis. LC cells induce nerve growth in the microenvironment by releasing neurotrophic factors (NTFs), and they can also stimulate neurite formation by secreting axons and axon guides. Conversely, nerve endings secrete factors that attract LC cells; this is known as perineural invasion (PNI) and promotes the progression of the associated cancer. In this paper, we summarize the systematic understanding of the role of neuroregulation in the LC tumour microenvironment (TME) and ways in which the TME accelerates nerve growth, which is closely related to the occurrence of LC.
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Current Intraoperative Imaging Techniques to Improve Surgical Resection of Laryngeal Cancer: A Systematic Review. Cancers (Basel) 2021; 13:cancers13081895. [PMID: 33920824 PMCID: PMC8071167 DOI: 10.3390/cancers13081895] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Laryngeal cancer is a prevalent head and neck malignancy, with poor prognosis and low survival rates for patients with advanced disease. The recurrence rate for advanced laryngeal cancer is between 25 and 50%. In order to improve surgical resection of laryngeal cancer and reduce local recurrence rates, various intraoperative optical imaging techniques have been investigated. In this systematic review we identify these technologies, evaluating the current state and future directions of optical imaging for this indication. Evidently, the investigated imaging modalities are generally unsuitable for deep margin assessment, and, therefore, inadequate to guide resection in advanced laryngeal disease. We discuss two optical imaging techniques that can overcome these limitations and suggest how they can be used to achieve adequate margins in laryngeal cancer at all stages. Abstract Laryngeal cancer is a prevalent head and neck malignancy, with poor prognosis and low survival rates for patients with advanced disease. Treatment consists of unimodal therapy through surgery or radiotherapy in early staged tumors, while advanced stage tumors are generally treated with multimodal chemoradiotherapy or (total) laryngectomy followed by radiotherapy. Still, the recurrence rate for advanced laryngeal cancer is between 25 and 50%. In order to improve surgical resection of laryngeal cancer and reduce local recurrence rates, various intraoperative optical imaging techniques have been investigated. In this systematic review, we identify these technologies, evaluating the current state and future directions of optical imaging for this indication. Narrow-band imaging (NBI) and autofluorescence (AF) are established tools for early detection of laryngeal cancer. Nonetheless, their intraoperative utility is limited by an intrinsic inability to image beyond the (sub-)mucosa. Likewise, contact endoscopy (CE) and optical coherence tomography (OCT) are technically cumbersome and only useful for mucosal margin assessment. Research on fluorescence imaging (FLI) for this application is sparse, dealing solely with nonspecific fluorescent agents. Evidently, the imaging modalities that have been investigated thus far are generally unsuitable for deep margin assessment. We discuss two optical imaging techniques that can overcome these limitations and suggest how they can be used to achieve adequate margins in laryngeal cancer at all stages.
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Esmaeili N, Boese A, Davaris N, Arens C, Navab N, Friebe M, Illanes A. Cyclist Effort Features: A Novel Technique for Image Texture Characterization Applied to Larynx Cancer Classification in Contact Endoscopy-Narrow Band Imaging. Diagnostics (Basel) 2021; 11:432. [PMID: 33802625 PMCID: PMC8001098 DOI: 10.3390/diagnostics11030432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Feature extraction is an essential part of a Computer-Aided Diagnosis (CAD) system. It is usually preceded by a pre-processing step and followed by image classification. Usually, a large number of features is needed to end up with the desired classification results. In this work, we propose a novel approach for texture feature extraction. This method was tested on larynx Contact Endoscopy (CE)-Narrow Band Imaging (NBI) image classification to provide more objective information for otolaryngologists regarding the stage of the laryngeal cancer. METHODS The main idea of the proposed methods is to represent an image as a hilly surface, where different paths can be identified between a starting and an ending point. Each of these paths can be thought of as a Tour de France stage profile where a cyclist needs to perform a specific effort to arrive at the finish line. Several paths can be generated in an image where different cyclists produce an average cyclist effort representing important textural characteristics of the image. Energy and power as two Cyclist Effort Features (CyEfF) were extracted using this concept. The performance of the proposed features was evaluated for the classification of 2701 CE-NBI images into benign and malignant lesions using four supervised classifiers and subsequently compared with the performance of 24 Geometrical Features (GF) and 13 Entropy Features (EF). RESULTS The CyEfF features showed maximum classification accuracy of 0.882 and improved the GF classification accuracy by 3 to 12 percent. Moreover, CyEfF features were ranked as the top 10 features along with some features from GF set in two feature ranking methods. CONCLUSION The results prove that CyEfF with only two features can describe the textural characterization of CE-NBI images and can be part of the CAD system in combination with GF for laryngeal cancer diagnosis.
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Affiliation(s)
- Nazila Esmaeili
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.B.); (M.F.); (A.I.)
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University Munich, 85748 Munich, Germany;
| | - Axel Boese
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.B.); (M.F.); (A.I.)
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany; (N.D.); (C.A.)
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany; (N.D.); (C.A.)
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University Munich, 85748 Munich, Germany;
| | - Michael Friebe
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.B.); (M.F.); (A.I.)
- IDTM GmbH, 45657 Recklinghausen, Germany
| | - Alfredo Illanes
- INKA—Innovation Laboratory for Image Guided Therapy, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (A.B.); (M.F.); (A.I.)
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Scholman C, Westra JM, Zwakenberg MA, Dikkers FG, Halmos GB, Wedman J, Wachters JE, van der Laan BFAM, Plaat BEC. High-definition videolaryngoscopy is superior to fiberoptic laryngoscopy: a 111 multi-observer study. Eur Arch Otorhinolaryngol 2021; 278:1927-1932. [PMID: 33606082 PMCID: PMC8131328 DOI: 10.1007/s00405-021-06673-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/01/2021] [Indexed: 11/24/2022]
Abstract
Purpose This study aims to analyse differences in fiberoptic laryngoscopy (FOL) versus high definition laryngoscopy (HDL) by examining videolaryngoscopy images by a large group of observers with different levels of clinical expertise in ear, nose and throat (ENT) medicine. Methods This study is a 111 observer paired analysis of laryngoscopy videos during an interactive presentation. During a National Meeting of the Dutch Society of ENT/Head and Neck Surgery, observers assessed both FOL and HDL videos of nine cases with additional clinical information. Observers included 41 ENT consultants (36.9%), 34 ENT residents (30.6%), 22 researchers with Head and Neck interest (19.8%) and 14 with unspecified clinical expertise (12.6%). For both laryngoscopic techniques, sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were determined for identifying a normal glottis, hyperkeratosis, radiotherapy adverse effects and squamous cell carcinoma. The sensitivities for FOL and HDL were analysed with regard to the different levels of clinical expertise. Results The overall sensitivity for correctly identifying the specific histological entity was higher in HDL (FOL 61% vs HDL 66.3%, p < 0.05). HDL was superior to FOL in identifying a normal glottis (FOL 68.1% vs HDL 91.6%, p < 0.01) and squamous cell carcinoma (FOL 70.86% vs HDL 79.41%, p = 0.02). Residents and researchers with Head and Neck interest diagnosed laryngeal lesions more correctly with HDL (p < 0.05). Conclusions In a large population of observers with different levels of clinical expertise, HDL is superior to FOL in identifying laryngeal lesions.
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Affiliation(s)
- Constanze Scholman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
| | - Jeroen M Westra
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Manon A Zwakenberg
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Frederik G Dikkers
- Department of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Jan E Wachters
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Department of Otorhinolaryngology-Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Boudewijn E C Plaat
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center, Groningen Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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23
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Zwakenberg MA, Halmos GB, Wedman J, van der Laan BFAM, Plaat BEC. Evaluating Laryngopharyngeal Tumor Extension Using Narrow Band Imaging Versus Conventional White Light Imaging. Laryngoscope 2021; 131:E2222-E2231. [PMID: 33393666 DOI: 10.1002/lary.29361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE/HYPOTHESIS Comparing detection and extension of malignant tumors by flexible laryngoscopy in the outpatient setting with laryngoscopy under general anesthesia using both White Light Imaging (WLI) and Narrow Band Imaging (NBI). STUDY DESIGN Prospective study. METHODS Two hundred and thirty-three patients with laryngeal and pharyngeal lesions underwent flexible and rigid laryngoscopy, with both WLI and NBI. Extension of malignant lesions (n = 132) was compared between both techniques in detail. RESULTS Sensitivity of NBI during flexible endoscopy (92%), was comparable with that of WLI during rigid endoscopy (91%). The correlation of tumor extension between flexible and rigid laryngoscopy was high (rs = 0.852-0.893). The observed tumor extension was significantly larger when using NBI in both settings. The use of NBI during flexible laryngoscopy leads to upstaging (12%) and downstaging (2%) of the T classification. CONCLUSIONS NBI during flexible laryngoscopy could be an alternative to WLI rigid endoscopy. NBI improves visualization of tumor extension and accuracy of T staging. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E2222-E2231, 2021.
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Affiliation(s)
- Manon A Zwakenberg
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Boudewijn E C Plaat
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Laryngeal Lesion Classification Based on Vascular Patterns in Contact Endoscopy and Narrow Band Imaging: Manual Versus Automatic Approach. SENSORS 2020; 20:s20144018. [PMID: 32707740 PMCID: PMC7411577 DOI: 10.3390/s20144018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/17/2020] [Accepted: 07/18/2020] [Indexed: 12/20/2022]
Abstract
Longitudinal and perpendicular changes in the vocal fold’s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evaluation of vascular patterns in CE-NBI images is challenging and highly depends on the clinicians’ experience. The current study aims to evaluate and compare the performance of a manual and an automatic approach for laryngeal lesion’s classification based on vascular patterns in CE-NBI images. In the manual approach, six observers visually evaluated a series of CE+NBI images that belong to a patient and then classified the patient as benign or malignant. For the automatic classification, an algorithm based on characterizing the level of the vessel’s disorder in combination with four supervised classifiers was used to classify CE-NBI images. The results showed that the manual approach’s subjective evaluation could be reduced by using a computer-based approach. Moreover, the automatic approach showed the potential to work as an assistant system in case of disagreements among clinicians and to reduce the manual approach’s misclassification issue.
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Sannino NJB, Mehlum CS, Grøntved ÅM, Kjaergaard T, Kiss K, Godballe C, Tvedskov JF. Incidence and malignant transformation of glottic precursor lesions in Denmark. Acta Oncol 2020; 59:596-602. [PMID: 32098535 DOI: 10.1080/0284186x.2020.1730437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Glottic precursor lesion (GPL) is a well-known premalignant condition, but the existing knowledge of incidence and malignant potential is based on subpopulation studies. In this first, nationwide study we report data from all verified cases of GPL in Denmark during a 10-year period with focus on incidence and malignant transformation of GPL.Methods: Patients were identified by a search for GPL in the time period from 01.01.2000 to 31.12.2009 using the Danish Pathology Data Base, Patobank, which is a nationwide source of all cyto- and histopathological data obtained in Denmark. Data were validated and supplemented by medical chart review.Results: A 10-year national cohort of 965 patients (median age 60 years, male-female ratio 2:1) with histologically verified GPL was analyzed. The overall malignant transformation rate was 18.3% (mild dysplasia 7.7%, moderate dysplasia 19.8%, severe dysplasia 28.5%, and carcinoma in situ 40.3%) with a median progression time of 29 months. Eighty-eight percent of patients were active or former smokers. A significantly larger proportion of male patients (24.1%) experienced malignant transformation compared to females (6.6%) (p < .001).Conclusion: This nationwide population-based study of GPL patients confirmed a stable incidence of GPL in Denmark from January 2000 to December 2009 and a considerable malignant potential, correlated to the grading of GPL according to the World Health Organization classification of laryngeal precursor lesions from 2005, WHOC2005. The recent update, WHOC2017, of low-grade versus high-grade lesions may thus contain less nuanced prognostic information than WHOC2005.Level of evidence: 2b retrospective cohort study.
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Affiliation(s)
- Nina J. B. Sannino
- Rigshospitalet, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University of Copenhagen, Copenhagen, Denmark
| | - Camilla S. Mehlum
- Department of ORL – Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ågot M. Grøntved
- Department of ORL – Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Katalin Kiss
- Rigshospitalet, Department of Pathology, Copenhagen, Denmark
| | - Christian Godballe
- Department of ORL – Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jesper F. Tvedskov
- Rigshospitalet, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University of Copenhagen, Copenhagen, Denmark
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Esmaeili N, Illanes A, Boese A, Davaris N, Arens C, Friebe M. A Preliminary Study on Automatic Characterization and Classification of Vascular Patterns of Contact Endoscopy Images .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2703-2706. [PMID: 31946453 DOI: 10.1109/embc.2019.8857145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The structure and organization of blood vessels in the vocal fold go through changes during the advancement from healthy to benign and further on to malignant stages. Contact Endoscopy (CE) is an optical technique providing real-time information related to the vascular structure of laryngeal mucosa. However, this technique comes with subjectivity in the interpretation of vascular patterns. In this study, a novel automated approach is proposed for vessel pattern charac-terization and classification of larynx CE + Narrow Band Imaging (NBI) images. This method is mainly based on the computation of indicators related to the level of disorder of vessels. 12 features were extracted from the indicators and were fed into two supervised classifiers. Linear Support Vector Machine (SVM) and K-Nearest Neighbor (KNN) showed an accuracy of 95.76% and 93.92% for vascular patterns and 86.04% and 82.23% for larynx histopathologies classification, respectively. These promising results show that the proposed method can potentially solve the subjectivity issues of CE.
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27
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Mehlum CS, Døssing H, Davaris N, Giers A, Grøntved ÅM, Kjaergaard T, Möller S, Godballe C, Arens C. Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy. Eur Arch Otorhinolaryngol 2020; 277:2485-2492. [PMID: 32350646 DOI: 10.1007/s00405-020-06000-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/18/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Combined use of contact endoscopy (CE) and Narrow Band Imaging (NBI, Olympus®) is suggested for the visualization of specific vascular changes indicative of glottic neoplasia. We investigated the interrater reliability and agreement in 3 recognized classification systems of vascular changes applied to images from CE + NBI in patients suspected for glottic neoplasia. METHODS Six experienced head and neck surgeons familiar with NBI rated 120 images obtained by CE + NBI by 3 classification systems of vascular changes as suggested by Ni et al. (N-C), Puxeddu et al. (P-C), and the European Laryngological Society (ELS-C). Three raters were experienced in CE, and three raters had only limited experience with CE. Crude agreement and Fleiss' kappa with 95% confidence interval were estimated for all 6 raters, and for the 2 levels of expertise for each original classification system and for dichotomized versions of the N-C and the P-C based on suggested neoplastic potential. RESULTS The interrater crude agreement and the corresponding kappa values for the ELS-C were good and significantly higher than those for the N-C and P-C for all raters, irrespective of the level of experience with CE (p < 0.0001). There were no significant differences between the N-C and the P-C (p = 0.16). Kappa was considerably improved for both the N-C and the P-C to a level not different from the ELS-C (p = 0.21-0.71) when their 5 original categories were pooled into dichotomized classifications. CONCLUSION Difficulties in reliably classifying vascular changes in CE + NBI are evident. Two-tier classification systems are the most reliable.
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Affiliation(s)
- Camilla Slot Mehlum
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark.
| | - Helle Døssing
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Anja Giers
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
| | - Ågot Møller Grøntved
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology‑Head and Neck Surgery, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 165, 8200, Aarhus N, Denmark
| | - Sören Möller
- OPEN ‑ Open Patient Data Explorative Network and Department of Clinical Research, Odense University Hospital and University of Southern Denmark, J. B. Winsløwsvej 9, 5000, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Otto-von-Guericke University, Magdeburg, Germany
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Loss of Estrogen Receptors is Associated with Increased Tumor Aggression in Laryngeal Squamous Cell Carcinoma. Sci Rep 2020; 10:4227. [PMID: 32144339 PMCID: PMC7060328 DOI: 10.1038/s41598-020-60675-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/20/2020] [Indexed: 01/27/2023] Open
Abstract
Laryngeal squamous cell carcinoma (LSCC) responds to 17β-estradiol via estrogen-receptor (ER, transcribed from ESR1) dependent mechanisms, but is not recognized as a hormonally responsive cancer. 17β-estradiol production by LSCC cell lines UM-SCC-11A and UM-SCC-12 was examined. Wild type (WT) and ESR1-silenced LSCC cultures and xenografts were examined for 17β-estradiol responsiveness in vivo. 14 LSCC and surrounding epithelial samples at various pathological stages were obtained from patients; ERα and ERβ expression were verified using data from the total cancer genome atlas. UM-SCC-11A and UM-SCC-12 both produce 17β-estradiol, but only UM-SCC-12, not UM-SCC-11A, xenograft tumors grow larger in vivo in response to systemic 17β-estradiol treatments. ERα66 and ERα36 expression inversely correlated with clinical cancer stage and tumor burden. LSCC ERα66 expression was higher compared to surrounding epithelia in indolent samples but lower in aggressive LSCC. ERβ expression was highly variable. High ESR1 expression correlated with improved survival in LSCC. Loss of ERα66 expression inversely correlated with prognosis in LSCC. ERα66 may be a histopathological marker of aggression in LSCC.
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29
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Garrel R, Uro Coste E, Costes-Martineau V, Woisard V, Atallah I, Remacle M. Vocal-fold leukoplakia and dysplasia. Mini-review by the French Society of Phoniatrics and Laryngology (SFPL). Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:399-404. [PMID: 32001196 DOI: 10.1016/j.anorl.2020.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vocal-fold leukoplakia and dysplasia are together designated "epithelial hyperplastic laryngeal lesions" (EHLL). Work-up and follow-up are founded on optical examination with high-definition imaging, stroboscopy and narrow-band imaging. Diagnosis is based on pathology, using the new 2017 WHO classification, dichotomizing "low grade" and "high grade". Statistically, the risk of cancerous progression is 20% within 5 to 10 years of diagnosis, or more in over-65 year-old males; risk for any given patient, however, is unpredictable. Research focuses on the genetic criteria of the lesion and characterization of the tumoral microenvironment. Treatment is exclusively microsurgical. Resection depth is adjusted according to infiltration. EHLL is a chronic disease, necessitating long-term follow-up, which may be hampered by residual dysphonia and surgical sequelae in the vocal folds. Sequelae need to be minimized by good mastery of microsurgical technique and indications. When they occur, biomaterials such as autologous fat and hyaluronic acid can be useful. Tissue bio-engineering is a promising field.
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Affiliation(s)
- R Garrel
- Département d'ORL et CCF, hôpital Gui de Chauliac, 80, avenue Fliche, 34295 Montpellier, France.
| | - E Uro Coste
- CHU Toulouse, département d'anatomopathologie, hôpital de Rangueil, avenue Jean-Poulhes, 31400 Toulouse, France
| | - V Costes-Martineau
- Département d'anatomopathologie, hôpital Gui de Chauliac, 80, avenue Fliche, 34295 Montpellier, France
| | - V Woisard
- CHU département d'ORL et CCF hôpital Larrey, 24, Chemin de Pouvourville - TSA 30030, 31059 Toulouse cedex 9, France
| | - I Atallah
- CHU département d'ORL et CCF, hôpital La tronche, Boulevard de la Chantourne, Grenoble, France
| | - M Remacle
- Département d'ORL et CCF, CHL centre, 4, Rue Ernest Barblé, L-1210 Luxembourg
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Davaris N, Lux A, Esmaeili N, Illanes A, Boese A, Friebe M, Arens C. Evaluation of Vascular Patterns Using Contact Endoscopy and Narrow-Band Imaging (CE-NBI) for the Diagnosis of Vocal Fold Malignancy. Cancers (Basel) 2020; 12:cancers12010248. [PMID: 31968528 PMCID: PMC7016896 DOI: 10.3390/cancers12010248] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/11/2020] [Accepted: 01/16/2020] [Indexed: 02/06/2023] Open
Abstract
The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with vocal fold cancer, dysplastic lesions, and papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). The combination of contact endoscopy with narrow-band imaging (NBI-CE) allows intraoperatively a highly contrasted, real-time visualization of vascular changes of the vocal folds. Aim of the present study was to determine the association of PVC to specific histological diagnoses, the level of interobserver agreement in the detection of PVC, and their diagnostic effectiveness in diagnosing laryngeal malignancy. The evaluation of our data confirmed the association of PVC to vocal fold cancer, dysplastic lesions, and papillomatosis. The level of agreement between the observers in the identification of PVC was moderate for the less-experienced observers and almost perfect for the experienced observers. The identification of PVC during NBI-CE proved to be a valuable indicator for diagnosing malignant and premalignant lesions.
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Affiliation(s)
- Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany
| | - Anke Lux
- Institute of Biometry and Medical Informatics, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Nazila Esmaeili
- Institute of Medical Technology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
| | - Alfredo Illanes
- Institute of Medical Technology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
| | - Axel Boese
- Institute of Medical Technology, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
| | - Michael Friebe
- Faculty of Medicine, Otto-von-Guericke-University, 39120 Magdeburg, Germany and IDTM GmbH, 45657 Recklinghausen, Germany
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany
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Scholman C, Westra JM, Zwakenberg MA, Dikkers FG, Halmos GB, Wedman J, Wachters JE, van der Laan BFAM, Plaat BEC. Differences in the diagnostic value between fiberoptic and high definition laryngoscopy for the characterisation of pharyngeal and laryngeal lesions: A multi-observer paired analysis of videos. Clin Otolaryngol 2019; 45:119-125. [PMID: 31747481 PMCID: PMC6972529 DOI: 10.1111/coa.13476] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES High definition laryngoscopy (HDL) could lead to better interpretation of the pharyngeal and laryngeal mucosa than regularly used fiberoptic laryngoscopy (FOL). The primary aim of this study is to quantify the diagnostic advantage of HDL over FOL in detecting mucosal anomalies in general, in differentiating malignant from benign lesions and in predicting specific histological entities. The secondary aim is to analyse image quality of both laryngoscopes. DESIGN Retrospective paired analysis with multiple observers evaluating endoscopic videos simulating daily clinical practice. SETTING A tertiary referral hospital. PARTICIPANTS In 36 patients, both FOL and HDL videos were obtained. Six observers were provided with additional clinical information, and 36 FOL and HDL videos were evaluated in a randomised order. MAIN OUTCOME MEASURES Sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of observers using both flexible laryngoscopes were calculated for detection of mucosal lesions in general and uncovering malignant lesions. Sensitivities were calculated for prediction of specific histological entities. Image quality (scale 1-10) was assessed for both flexible laryngoscopes. RESULTS HDL reached higher sensitivity compared to FOL for detection of mucosal abnormalities in general (96.0% vs 90.4%; P = .03), differentiating malignant from benign lesions (91.7% vs 79.8%; P = .03) and prediction of specific histological entities (59.7% vs 47.2%; P < .01). Image quality was judged better with HDL in comparison with FOL (mean: 8.4 vs 5.4, P < .01). CONCLUSIONS HDL is superior to FOL in detecting mucosal anomalies in general, malignancies and specific histological entities. Image quality is considered as superior using HDL compared to FOL.
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Affiliation(s)
- Constanze Scholman
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeroen M Westra
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Manon A Zwakenberg
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frederik G Dikkers
- Department of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan E Wachters
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Boudewijn E C Plaat
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Laser induced autofluorescence lifetime to identify larynx squamous cell carcinoma: Short series ex vivo study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 202:111724. [PMID: 31785446 DOI: 10.1016/j.jphotobiol.2019.111724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 02/08/2023]
Abstract
Laser induced autofluorescence (LIAF) lifetime is useful to distinguish between normal laryngeal tissues and squamous cell carcinoma (SCC) based on variations of their biochemical composition and structure alterations. LIAF was collected from samples constituted by pairs of normal and malignant tissue, which were excised from three patients. Exclusion criteria for samples harvest were: (i) macroscopic changes of normal vocal cord observed during surgery; (ii) previous surgical intervention on vocal cord, (iii) patients treated only with chemotherapy or radiotherapy for carcinoma. Inclusion conditions: men, aged 57-68, non-smokers. A pulsed laser diode excited LIAF at 375 nm and 31 MHz repetition rate; beam full-time width at half-maximum was 87 ps at an average power of 0.49 mW. Mean LIAF lifetime for normal tissues was (3.75 ± 0.49) ns and for malignant (4.37 ± 0.85) ns: it is longer in malignant than in normal tissue. Variance analysis made with Fisher's test has shown no significant difference between patients for normal tissues; the same was true for malignant. Though, when malignant tissue was compared to normal for the same patients as well as between patients, a significant difference (significance level of 5%) was evidenced. Time-resolved LIAF may allow better differentiation between normal and malignant tissues in patients diagnosed with larynx SCC.
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Mehlum CS, Kjaergaard T, Grøntved ÅM, Lyhne NM, Jørkov APS, Homøe P, Tvedskov JF, Bork KH, Möller S, Jørgensen G, Philipsen BB, Godballe C. Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia. Eur Arch Otorhinolaryngol 2019; 277:207-215. [PMID: 31654182 DOI: 10.1007/s00405-019-05698-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/12/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the individual and combined ability of videostroboscopy (VS), high-speed digital imaging (HSDI), enhanced endoscopy (EE) and saline infusion (SI) to predict neoplasia, defined as glottic precursor lesion (GPL) or T1a glottic cancer, in patients suspected for glottic neoplasia. METHODS A nationwide prospective cohort study of patients treated by cordectomy for suspected GPL or T1a glottic cancer from August 1st 2016 to October 31st 2018 was conducted in the five Danish University Departments of Head and Neck surgery. Sensitivity, specificity, negative and positive predictive values, and area under Receiver Operating Curves (AUC-ROC) were calculated with 95% confidence intervals with respect to the histological diagnosis. Logistic regression with an imputation model for missing data was applied. RESULTS 261 patients aged 34-91 years participated; 79 (30.3%) with non-neoplasia (i.e., inflammation, papilloma, hyperkeratosis) and 182 (69.7%) neoplasia, hereof 95 (36.4%) with GPL and 87 (33.3%) with T1a glottic cancer. Data from 188 VS, 60 HSDI, 100 preoperative EE, 209 intraoperative EE, and 234 SI were analyzed. In the complete case analysis the AUC-ROC of each diagnostic test was low, but increased when the tests were combined and especially if the combination included EE. However, multinomial logistic regression with imputation showed significant association (p < 0.05) only between age, male gender, and perpendicular vasculature in intraoperative EE, and the endpoint neoplasia. CONCLUSIONS Intraoperative EE was the most accurate diagnostic method in detecting neoplasia. The prediction ability of methods applied preoperatively was more limited, but improved when test modalities were combined.
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Affiliation(s)
- Camilla Slot Mehlum
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark.
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology-Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark
| | - Ågot Møller Grøntved
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Nina Munk Lyhne
- Department of Head and Neck Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | | | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark
| | - Jesper Filtenborg Tvedskov
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kristian Hveysel Bork
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Sören Möller
- OPEN-Open Patient Data Explorative Network and Department of Clinical Research, Odense University Hospital and University of Southern Denmark, J. B. Winsløwsvej 9, 5000, Odense, Denmark
| | - Gita Jørgensen
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Bahareh Bakhshaie Philipsen
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, J. B. Winsløwsvej 4, 5000, Odense, Denmark
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Xi J, Wang Y, Liu H. GLUT-1 participates in the promotion of LncRNA CASC9 in proliferation and metastasis of laryngeal carcinoma cells. Gene 2019; 726:144194. [PMID: 31669650 DOI: 10.1016/j.gene.2019.144194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/09/2019] [Accepted: 10/20/2019] [Indexed: 01/06/2023]
Abstract
Increasing evidence indicates that long non-coding RNA (lncRNA) may play important roles in tumorigenesis. Increased lncRNA CASC9 occurs in laryngeal carcinoma, which accounts for 20% of all head and neck cancers, but its role in this disease remains unknown. Using quantitative reverse transcriptase PCR, we found higher expression of CASC9 and GLUT-1 in laryngeal carcinoma tissues and cells, compared to adjacent tissues and cells. A correlation analysis showed a positive relationship between CASC9 and GLUT-1 expression in laryngeal carcinoma tissues. An MTT assay of TU212 and Hep-2 cells showed increased cell proliferation after transfection with overexpressed CASC9 and decreased cell proliferation after transfection with silenced CASC9. A Transwell assay showed that overexpressing CASC9 increased and silencing CASC9 decreased cell migration of TU212 and Hep-2 cells. A flow cytometry assay showed that overexpressing CASC9 reduced and silencing CASC9 increased cell apoptosis. In other words, we found that overexpressing CASC9 increased cell proliferation and cell migration and decreased apoptosis both in TU212 and Hep-2 cells, whereas silencing CASC9 had the opposite effects. Moreover, overexpression vector of GLUT-1 was used to investigate the molecular mechanism of CASC9 in laryngeal carcinoma. The results showed that transfection with an overexpressed GLUT-1vector reversed the effects of silencing CASC9 on proliferation, migration, and apoptosis in TU212 and Hep-2 cells. In conclusion, our study of laryngeal carcinoma found that CASC9 was positively correlated with GLUT-1 expression and that CASC9 may promote proliferation and metastasis of laryngeal carcinoma cells by regulating GLUT-1.
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Affiliation(s)
- Jie Xi
- Otorhinolaryngology, Shaanxi Provincial People's Hospital, Third Affiliated Hospital of Xi'an Jiaotong University, 710068 Xi'an, Shaanxi, China
| | - Yong Wang
- Otorhinolaryngology, Yangling Demonstration Zone Hospital, 712100 Xi'an, Shaanxi, China
| | - Hui Liu
- Otorhinolaryngology, Shaanxi Provincial People's Hospital, 710068 Xi'an, Shaanxi, China; Institute of Medicine, Northwestern Polytechnical University, 710072 Xi'an, Shaanxi, China.
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Cardoso CM, de Jesus SF, de Souza MG, Queiroz LDRP, Santos EM, Dos Santos EP, Oliveira LP, Cordeiro Santos CK, Santos SHS, de Paula AMB, Farias LC, Guimaraes ALS. High levels of ANXA2 are characteristic of malignant salivary gland tumors. J Oral Pathol Med 2019; 48:929-934. [PMID: 31325182 DOI: 10.1111/jop.12932] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Malignant salivary gland tumors (MSGTs) present different phenotypic characteristics and various clinical outcomes, which proved to be a diagnostic challenge. Considering the heterogeneity of MSGT, this study aims to identify molecule related to the nature of MSGT. METHODS For screening, proteomic analysis comparing MSGT with pleomorphic adenoma (PA) and salivary gland was performed. The MSGT-associated protein which presented in the higher number in the Gene Expression Omnibus (GEO) database was selected. To validate the data, immunohistochemistry (IHC) was performed in 14 patients with PA, 22 patients with MSGT, and 14 controls. RESULTS 16 proteins were associated with MSGT. ANXA2 was the primary protein, according to GEO database analyses. ANXA2 was most expressed in the cell membrane. However, some ANXA2 staining was also observed in the cytoplasm and nucleus. ANXA2 was highly expressed in MSGT in comparison with control. Also, ANXA2 has a higher expression in adenocarcinoma not otherwise specified (ANOS) and myoepithelial carcinoma (MC) in comparison with PA. CONCLUSION In conclusion, this study demonstrated that MSGT presented higher levels of ANXA2 in comparison with normal salivary glands. Also, ANXA2 might be interesting as a molecular marker of ANOS and MS.
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Affiliation(s)
- Claudio Marcelo Cardoso
- Department of Medicine, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil.,Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil
| | - Sabrina Ferreira de Jesus
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | | | - Eloa Mangabeira Santos
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Luis Paulo Oliveira
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Sérgio Henrique Sousa Santos
- Institute of Agricultural Sciences, Food Engineering College, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Andre Luiz Sena Guimaraes
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil.,Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil
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Esmaeili N, Illanes A, Boese A, Davaris N, Arens C, Friebe M. Novel automated vessel pattern characterization of larynx contact endoscopic video images. Int J Comput Assist Radiol Surg 2019; 14:1751-1761. [PMID: 31352673 PMCID: PMC6797664 DOI: 10.1007/s11548-019-02034-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022]
Abstract
Purpose Contact endoscopy (CE) is a minimally invasive procedure providing real-time information about the cellular and vascular structure of the superficial layer of laryngeal mucosa. This method can be combined with optical enhancement methods such as narrow band imaging (NBI). However, these techniques have some problems like subjective interpretation of vascular patterns and difficulty in differentiation between benign and malignant lesions. We propose a novel automated approach for vessel pattern characterization of larynx CE + NBI images in order to solve these problems. Methods In this approach, five indicators were computed to characterize the level of vessel’s disorder based on evaluation of consistency of gradient and two-dimensional curvature analysis and then 24 features were extracted from these indicators. The method evaluated the ability of the extracted features to classify CE + NBI images based on the vascular pattern and based on the laryngeal lesions. Four datasets were generated from 32 patients involving 1485 images. The classification scenarios were implemented using four supervised classifiers. Results For classification of CE + NBI images based on the vascular pattern, polykernel support vector machine (SVM), SVM with radial basis function (RBF), k-nearest neighbor (kNN), and random forest (RF) show an accuracy of 97%, 96%, 96%, and 96%, respectively. For the classification based on the histopathology, Polykernel SVM showed an accuracy of 84%, 86% and 84%, RBF SVM showed an accuracy of 81%, 87% and 83%, kNN showed an accuracy of 89%, 87%, 91%, RF showed an accuracy of 90%, 88% and 91% for classification between benign histopathologies, between malignant histopathologies and between benign and malignant lesions, respectively. Conclusion These promising results show that the proposed method could solve the problem of subjectivity in interpretation of vascular patterns and also support the clinicians in the early detection of benign, pre-malignant and malignant lesions.
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Affiliation(s)
- Nazila Esmaeili
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
| | - Alfredo Illanes
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Axel Boese
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Nikolaos Davaris
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Magdeburg, Germany
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, Magdeburg, Germany
| | - Michael Friebe
- INKA, Institute of Medical Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Ni X, Wang G, Hu F, Xu X, Xu L, Liu X, Chen X, Liu L, Ren X, Yang Y, Guo L, Gu Y, Hou J, Zhang J, Yang Y, Xing B, Ren J, Guo H. Clinical utility and effectiveness of a training programme in the application of a new classification of narrow‐band imaging for vocal cord leukoplakia: A multicentre study. Clin Otolaryngol 2019; 44:729-735. [PMID: 31074935 DOI: 10.1111/coa.13361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/10/2019] [Accepted: 04/29/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Xiao‐Guang Ni
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Gui‐Qi Wang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Feng‐Ying Hu
- Department of Otolaryngology Head and Neck Surgery Inner Mongolia North Hospital Baotou China
| | - Xin‐Mao Xu
- Department of Otorhinolaryngology Tengzhou Central People’s Hospital Tengzhou China
| | - Ling Xu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Inner Mongolia Medical University Hohhot China
| | - Xiao‐Qin Liu
- Department of Otorhinolaryngology Inner Mongolia People's Hospital Hohhot China
| | - Xue‐Song Chen
- Department of Otorhinolaryngology Binzhou City Center Hospital Binzhou China
| | - Lin Liu
- Department of Otolaryngology Head and Neck Surgery Dalian Municipal Friendship Hospital Dalian China
| | - Xue‐Lian Ren
- Department of eye and Otorhinolaryngology Weifang Maternal and Child Care Hospital Weifang China
| | - Yong Yang
- Department of Otolaryngology Head and Neck Surgery The People’s Hospital of Guangxi Zhuang Autonomous Region Nanning China
| | - Li Guo
- Department of Otolaryngology Head and Neck Surgery the First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology Luoyang China
| | - Ya‐Jun Gu
- Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Jin Hou
- Department of Otolaryngology Head and Neck Surgery the Second Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Jun‐Wei Zhang
- Department of Otorhinolaryngology Traditional Chinese Medicine Hospital of Ruzhou City Ruzhou China
| | - Yan Yang
- Department of Otorhinolaryngology the First People’s Hospital of Yunnan Province Kunming China
| | - Biao Xing
- Department of Otorhinolaryngology Cangzhou Central Hospital Cangzhou China
| | - Jia Ren
- Department of Otolaryngology Head and Neck Surgery West China Hospital, Sichuan University Chengdu China
| | - Hong‐Qiang Guo
- Department of Otorhinolaryngology Zaozhuang Municipal Hospital Zaozhuang China
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Ali SA, Smith JD, Hogikyan ND. The White Lesion, Hyperkeratosis, and Dysplasia. Otolaryngol Clin North Am 2019; 52:703-712. [PMID: 31078307 DOI: 10.1016/j.otc.2019.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Laryngeal mucosal precursor lesions represent a challenging clinical entity. Updated classification systems allow for grade-based categorization. Multiple management options exist, with treatment decisions made jointly by physician and patient and focused on both appropriate lesion treatment and preservation of laryngeal structure and function. Traditional methods include cold steel and CO2 laser excision, with newer modalities using angiolytic lasers for lesion ablation. Both operating room-based and office-based treatment options exist, and there are advantages and disadvantages to each approach. Research is ongoing to advance the understanding of lesion biology, and to optimize prevention and treatment.
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Affiliation(s)
- S Ahmed Ali
- Department of Otolaryngology - Head & Neck Surgery, Michigan Medicine, 1904 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5312, USA
| | - Joshua D Smith
- Department of Otolaryngology - Head & Neck Surgery, Michigan Medicine, 1904 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5312, USA
| | - Norman D Hogikyan
- Department of Otolaryngology - Head & Neck Surgery, Michigan Medicine, 1904 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5312, USA.
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Elders BBLJ, Hermelijn SM, Tiddens HAWM, Pullens B, Wielopolski PA, Ciet P. Magnetic resonance imaging of the larynx in the pediatric population: A systematic review. Pediatr Pulmonol 2019; 54:478-486. [PMID: 30680950 PMCID: PMC6590591 DOI: 10.1002/ppul.24250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/15/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Magnetic Resonance Imaging (MRI) techniques to image the larynx have evolved rapidly into a promising and safe imaging modality, without need for sedation or ionizing radiation. MRI is therefore of great interest to image pediatric laryngeal diseases. Our aim was to review MRI developments relevant for the pediatric larynx and to discuss future imaging options. METHODS A systematic search was conducted to identify all morphological and diagnostic studies in which MRI was used to image the pediatric larynx, laryngeal disease, or vocal cords. RESULTS Fourteen articles were included: three studies on anatomical imaging of the larynx, two studies on Diffusion Weighted Imaging, four studies on vocal cord imaging and five studies on the effect of anaesthesiology on the pediatric larynx. MRI has been used for pediatric laryngeal imaging since 1991. MRI provides excellent soft tissue contrast and good visualization of vascular diseases such as haemangiomas. However, visualization of cartilaginous structures, with varying ossification during childhood, and tissue differentiation remain challenging. The latter has been partly overcome with diffusion weighted imaging (DWI), differentiating between benign and malignant masses with excellent sensitivity (94-94.4%) and specificity (91.2-100%). Vocal cord imaging evolved from static images focused on vocal tract growth to dynamic images able to detect abnormal vocal cord movement. CONCLUSION MRI is promising to evaluate the pediatric larynx, but studies using MRI as diagnostic imaging modality are scarce. New static and dynamic MR imaging techniques could be implemented in the pediatric population. Further research on imaging of pediatric laryngeal diseases should be conducted.
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Affiliation(s)
- Bernadette B L J Elders
- Department of Paediatric Pulmonology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Sergei M Hermelijn
- Department of Paediatric Pulmonology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Harm A W M Tiddens
- Department of Paediatric Pulmonology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Bas Pullens
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Pjotr A Wielopolski
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Pierluigi Ciet
- Department of Paediatric Pulmonology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
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Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery. Eur Arch Otorhinolaryngol 2018; 276:459-466. [PMID: 30569190 PMCID: PMC6394425 DOI: 10.1007/s00405-018-5256-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/14/2018] [Indexed: 12/15/2022]
Abstract
Purpose Flexible transnasal endoscopy is a common examination technique for the evaluation of laryngeal lesions, while the use of narrow band imaging (NBI) has been reported to enhance the diagnostic value of white light endoscopy (WLE). The purpose of this study is to assess observer variability and diagnostic value of both modalities and investigate the possible influence of previous laryngeal surgery on the detection rates of laryngeal malignancy. Methods The study was based on the retrospective evaluation of 170 WLE and NBI images of laryngeal lesions by three observers in a random order. The histopathological diagnoses serve as the gold standard. Results In identifying laryngeal malignancy, the sensitivity of NBI proved to be higher than that of WLE (93.3% vs. 77.0%). NBI was also superior to WLE in terms of accuracy (96.3% vs. 92%) and diagnostic odds ratio (501.83 vs. 120.65). Both modalities had a specificity of 97.3%. The inter-observer agreement was substantial (kappa = 0.661) for WLE and almost perfect (kappa = 0.849) for NBI. Both WLE and NBI showed a high level of intra-observer agreement. The sensitivity was significantly lower in images with history of previous laryngeal surgery compared to those without. Conclusions Flexible transnasal endoscopy has been proved to be a valuable tool in the diagnosis of laryngeal malignancy. The use of NBI can increase the sensitivity and observer reliability in that context and can also provide a diagnostic gain in cases with previous laryngeal surgery
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Lazio MS, Vallin A, Giannini C, Taverna C, Maggiore G, Saraceno MS, Gallo O. Phonosurgical Resection Using Submucosal Infusion Technique for Early Glottic Lesions: Diagnostic and Therapeutic Procedure? Ann Otol Rhinol Laryngol 2018; 128:277-285. [PMID: 30547680 DOI: 10.1177/0003489418819544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES: The aim of this study was to assess the feasibility of the submucosal infusion combined with microflap dissection via laser CO2 as both a diagnostic and therapeutic procedure for superficial glottic lesions. To define a safe surgical procedure in terms of local control, a morphometric study of surgical margins was performed. METHODS: From January 2011 to January 2016, we treated 122 patients with early glottic lesions with phonomicrosurgery. Patients with effective hydrodissection underwent a microflap and type I-II diagnostic cordectomy. In the others, a biopsy was carried out, and in the case of a malignant lesion, a type III to VI cordectomy was performed. Disease-free survival (DFS) for all the lesions was also determined according to comparative assessments of surgical margins. The Voice Handicap Index was used to evaluate functional outcomes. RESULTS: In 27 cases (32%), hydrodissection was effective; specifically, 24 (88.8%) were premalignant lesions, and 3 (11.2%) had a carcinoma. In 56 patients (68%), hydrodissection was not adequate, and a biopsy was performed: 9 (16%) were premalignant and 47 (84%) malignant lesions. The DFS analysis suggests that margins >0.7 mm resulted in a cutoff that can guarantee a safe procedure in the case of effective hydrodissection ( P < .05). CONCLUSION: Phonomicrosurgery may be both a diagnostic and therapeutic option with oncological efficacy for superficial glottic lesions of undetermined nature when surgical margins exceed 0.7 mm. In case of inadequate hydrodissection, the hypothesis of an infiltrative carcinoma warrants a wider cordectomy.
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Affiliation(s)
- Maria Silvia Lazio
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
| | - Alberto Vallin
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
| | - Costanza Giannini
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
| | - Cecilia Taverna
- 2 Section of Anatomic Pathology, Department of Surgery and Translational Medicine, Careggi University Hospital, Florence, Italy
| | - Giandomenico Maggiore
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
| | - Massimo Squadrelli Saraceno
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
| | - Oreste Gallo
- 1 Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, Careggi University Hospital, Florence, Italy
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Anis MM. Correlating laryngoscopic appearance of laryngeal lesions with histopathology. Laryngoscope 2018; 129:1308-1312. [PMID: 30484864 DOI: 10.1002/lary.27585] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/29/2018] [Accepted: 08/28/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES/HYPOTHESIS Meticulous scrutiny of laryngeal lesions with laryngoscopes and microscopes often identify angiogenic activity, one of the hallmarks of neoplastic and preneoplastic lesions. The aim of this study was to determine if there is an association between laryngoscopic appearance and histopathology of laryngeal lesions based on operative biopsies. STUDY DESIGN Retrospective case-control study. METHODS One hundred forty-four laryngeal biopsies from 92 patients between 2015 and 2017 met inclusion criteria. Cases were patients who had biopsy-proven laryngeal dysplasia or malignancy. Controls were patients who had benign laryngeal pathology. All of the laryngeal lesions had either keratosis or vascular stippling, an indication of angiogenic activity. Medical records, videostroboscopies and operative findings of these patients were reviewed. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of laryngeal lesions and presence or absence of dysplasia and invasive carcinoma. RESULTS Fifty percent of the 144 laryngeal lesions were classified either as dysplastic or malignant by histopathology. Vascular stippling was present in 31% of all laryngeal lesions. On logistic regression, vascular stippling was significantly associated with dysplastic and malignant lesions (P = .0018). Overall sensitivity and specificity of vascular stippling and the presence of dysplasia and malignancy were 51% and 89%, respectively. CONCLUSIONS Laryngoscopic and microscopic appearance of vascular stippling could inform clinicians on diagnostic sampling of suspicious laryngeal lesions that reduces delay in diagnosis. The low sensitivity of vascular stippling underlies the importance of maintaining high clinical suspicion and proceeding to the operating theater for adequate tissue sampling. LEVEL OF EVIDENCE 3 Laryngoscope, 129:1308-1312, 2019.
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Affiliation(s)
- Mursalin M Anis
- Coastal Ear, Nose and Throat, Neptune, New Jersey; and the Jersey Shore University Medical Center, Neptune, New Jersey, U.S.A
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Caffier PP, Nawka T, Ibrahim-Nasr A, Thomas B, Müller H, Ko SR, Song W, Gross M, Weikert S. Development of three-dimensional laryngostroboscopy for office-based laryngeal diagnostics and phonosurgical therapy. Laryngoscope 2018; 128:2823-2831. [PMID: 30328614 DOI: 10.1002/lary.27260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/19/2018] [Accepted: 04/06/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To develop a three-dimensional (3D) laryngostroboscopic examination unit, compare the optic playback quality in relation to established 2D procedures, and report the first case series using 3D rigid laryngostroboscopy for diagnosis and management of laryngotracheal diseases. STUDY DESIGN Laboratory study, prospective case series. METHODS The optical efficacy of newly developed rigid 3D endoscopes was examined in a laboratory setting. Diagnostic suitability was investigated in 100 subjects (50 male, 50 female) receiving 2D high-definition (HD) and 3D laryngostroboscopy. Two of the subjects subsequently underwent 3D-assisted office-based transoral phonosurgery under local anesthesia. Main outcome measures were comparative visualization of laryngotracheal pathologies, influence on preoperative planning, and evaluation of prognostic factors for the outcome of phonosurgical interventions. RESULTS Three-dimensional endostroboscopic procedures were effectively optimized to establish an examination protocol for all-day clinical use. Office-based 3D laryngostroboscopy was successfully applied in subjects with normal anatomy (n = 10) and various laryngotracheal findings (n = 90). In comparison to 2D HD videolaryngostroboscopy, the 3D view offered enhanced visualization of laryngotracheal anatomy, with qualitatively improved depth perception and spatial representation. In organic pathologies, this resulted in a more precise indication of phonosurgical procedures, increased accuracy in surgical planning, facilitated office-based endoscopic surgery, and better evaluation of prognostic factors for the outcome of phonosurgical interventions. CONCLUSION Three-dimensional laryngostroboscopy proved to increase the understanding of functional and surgical anatomy. Its application has enormous potential for improving the diagnostic value of laryngoscopy, surgical precision in laryngotracheal interventions, tissue preservation, and methods of teaching. LEVEL OF EVIDENCE NA Laryngoscope, 128:2823-2831, 2018.
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Affiliation(s)
- Philipp P Caffier
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | - Tadeus Nawka
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | - Ahmed Ibrahim-Nasr
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | | | | | - Seo-Rin Ko
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | - Wen Song
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | - Manfred Gross
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
| | - Sebastian Weikert
- Department of Audiology and Phoniatrics, Charité-University Medicine Berlin, Berlin, Germany
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Ni XG, Zhu JQ, Zhang QQ, Zhang BG, Wang GQ. Diagnosis of vocal cord leukoplakia: The role of a novel narrow band imaging endoscopic classification. Laryngoscope 2018; 129:429-434. [PMID: 30229933 DOI: 10.1002/lary.27346] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 05/22/2018] [Indexed: 01/11/2023]
Affiliation(s)
- Xiao-Guang Ni
- Department of Endoscopy; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Ji-Qing Zhu
- Department of Endoscopy; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Qing-Qing Zhang
- Department of Endoscopy; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Bao-Gen Zhang
- Department of Endoscopy; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Gui-Qi Wang
- Department of Endoscopy; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
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Proposal of a form for the collection of videolaryngostroboscopy basic findings. Eur Arch Otorhinolaryngol 2018; 275:1927-1933. [PMID: 29789936 PMCID: PMC5992234 DOI: 10.1007/s00405-018-4991-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/30/2018] [Indexed: 10/29/2022]
Abstract
Videolaryngostroboscopy is a useful investigation required for a correct diagnosis of laryngeal diseases and voice disorders. We present a form for the collection of basic laryngostroboscopic findings, which provides for the evaluation of the classical six parameters codified by Hirano (symmetry and periodicity of glottic vibration, glottic closure, profile of vocal fold edge, amplitude of vocal fold vibration, mucosal wave) and six other parameters which we have included in the form for an essential and complete laryngostroboscopic evaluation (supraglottic framework behaviour, seat of phonatory vibration, vocal fold morphology and motility, level of the vocal fold, stops of vocal fold mucosa vibration). This form was created in 2002 during the elaboration of the protocol for the assessment of dysphonia of the Italian Society of Phoniatrics and Logopedics, which follows the guidelines of the European Laryngological Society published in 2001. We used this form for 15 years in our daily laryngological practice with great satisfaction. We propose a more detailed version of this form, which provides for drawings which show the various videolaryngostroboscopic findings, helping the laryngologist in the collection of videolaryngostroboscopic examination basic findings.
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Yang Y, Fang J, Zhong Q, Xu W, Ma H, Feng L, Shi Q, Lian M, Wang R, Hou L. The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer. Acta Otolaryngol 2018; 138:400-406. [PMID: 29043905 DOI: 10.1080/00016489.2017.1388542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer. METHODS A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination. RESULTS We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%). CONCLUSION NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity.
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Affiliation(s)
- Yifan Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jugao Fang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
- Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing, China
| | - Qi Zhong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Wen Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Hongzhi Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Ling Feng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Qian Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Meng Lian
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Ru Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Lizhen Hou
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
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The value of narrow band imaging in diagnosis of head and neck cancer: a meta-analysis. Sci Rep 2018; 8:515. [PMID: 29323235 PMCID: PMC5765024 DOI: 10.1038/s41598-017-19069-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/21/2017] [Indexed: 02/08/2023] Open
Abstract
Head and neck cancer is difficult to diagnose early. We aimed to estimate the diagnosis value of narrow band imaging(NBI) in head and neck cancers. We identified relevant studies through a search of PubMed, Embase and the Cochrane Library. We used a random effect model. Subgroup analysis and meta-regression analysis were performed to estimate the factors which may influence the sensitivity and specificity of the NBI. We included 25 studies with total 6187 lesions. The pooled sensitivity, specificity, positive likelihood rate, negative likelihood rate and diagnostic odds ratios of NBI were 88.5%, 95.6%, 12.33, 0.11 and 121.26, respectively. The overall area under the curve of SROC was 96.94%. The location, type of assessment, type of endoscope system and high definition were not significant sources of heterogeneity (P > 0.05). However, magnification may be related to the source of heterogeneity (P = 0.0065). Therefore, NBI may be a promising endoscopic tool in the diagnosis of head and neck cancer.
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Luo S, Xie C, Wu P, He J, Tang Y, Xu J, Zhao S. Annexin A2 is an independent prognostic biomarker for evaluating the malignant progression of laryngeal cancer. Exp Ther Med 2017; 14:6113-6118. [PMID: 29285166 DOI: 10.3892/etm.2017.5298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/07/2017] [Indexed: 12/31/2022] Open
Abstract
Due to the lack of a definite diagnosis, a frequent recurrence rate and resistance to chemotherapy or radiotherapy, the clinical outcome for patients with advanced laryngeal cancer has not improved over the last decade. Annexin A2 is associated with the invasion and metastasis of cancer cells. In the present study, it was demonstrated using differential proteomics analysis that Annexin A2 is highly expressed in laryngeal carcinoma tissues and this was confirmed using immunohistochemistry, which demonstrated that the expression of Annexin A2 in laryngeal carcinoma tissues was significantly higher than in healthy adjacent tissue. In addition, its potential predictive value in the prognosis of patients with laryngeal carcinoma was evaluated. The results demonstrated that Annexin A2 expression was significantly associated with tumor size, lymph node metastasis, distant metastasis and clinical stage. In addition, higher Annexin A2 expression was associated with a poor prognosis of patients with laryngeal cancer. Thus, the results of the present study indicate that Annexin A2 expression is an independent prognostic biomarker for evaluating the malignant progression of laryngeal cancer.
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Affiliation(s)
- Shi Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Chubo Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Ping Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Jian He
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Yaoyun Tang
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Jing Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Suping Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
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Chen L, Jin M, Li C, Shang Y, Zhang Q. The tissue distribution and significance of B7-H4 in laryngeal carcinoma. Oncotarget 2017; 8:92227-92239. [PMID: 29190910 PMCID: PMC5696176 DOI: 10.18632/oncotarget.21152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 08/26/2017] [Indexed: 12/22/2022] Open
Abstract
The costimulatory signals CD28 and B7 have been shown to control tumor invasion and metastasis by regulating T cell activation, whereas the distribution characteristics of B7-associated proteins in laryngeal carcinoma (LC) tissue are still unclear. Here, the expression of members of the B7 superfamily, including B7-H1 (PD-L1), B7-DC (PD-L2) and B7-H4, in fifty-two LC samples was determined by immunohistochemistry, and the relationship between B7-H4 and epithelial-mesenchymal transition (EMT)-associated markers was further assessed by immunofluorescence double staining. Furthermore, the human LC cell lines, Hep-2 and TU212 cells, were further transfected to overexpress B7-H4, and cell invasion and metastasis were analyzed. The results showed that B7-H1, B7-DC and B7-H4 were expressed in the tumor cells, and their expression was restricted to the cell membrane and the cytoplasm. The positive rates of these molecules in the tumor tissues were 57.7% (30/52), 32.7% (17/52) and 34.6% (18/52), respectively. Interestingly, double immunofluorescence staining showed that B7-H4 is coexpression with EMT-related markers, including p-Smad2/3, Snail and Vimentin, in carcinoma cells. Moreover, overexpression of B7-H4 in Hep-2 cells promotes the expression of pSmad2/3 and Snail by activating AKT-STAT3 signaling. Transwell and wound-healing assays demonstrated that B7-H4 enhanced both Hep-2 and TU212 cell invasion and metastasis. Our results suggest that B7-H4 transmits feedback signaling to tumor cells and promotes invasion and metastasis by promoting EMT progression. Therefore, blocking B7-H4 signaling might be a novel treatment strategy for LC.
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Affiliation(s)
- Lili Chen
- Medical College, Dalian University, Dalian, People's Republic of China.,Department of Clinical Laboratory, Laiwu City People Hospital, Laiwu, People's Republic of China
| | - Meihua Jin
- Medical College, Dalian University, Dalian, People's Republic of China
| | - Chunshi Li
- Medical College, Dalian University, Dalian, People's Republic of China.,School of Pharmacy, Yanbian University, Yanji, People's Republic of China
| | - Yongjun Shang
- Medical College, Dalian University, Dalian, People's Republic of China.,Department of Orthopedics, Affiliated Hospital of Chifeng University, Chifeng, People's Republic of China
| | - Qinggao Zhang
- Medical College, Dalian University, Dalian, People's Republic of China
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Mehlum CS, Rosenberg T, Dyrvig AK, Groentved AM, Kjaergaard T, Godballe C. Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis. Laryngoscope 2017; 128:168-176. [DOI: 10.1002/lary.26721] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/23/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Camilla S. Mehlum
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | - Tine Rosenberg
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | | | - Aagot Moeller Groentved
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology-Head and Neck Surgery; Aarhus University Hospital; Aarhus Denmark
| | - Christian Godballe
- Department of Otorhinolaryngology-Head and Neck Surgery; Odense University Hospital; Odense Denmark
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