Value of fluorescence endoscopy for the early diagnosis of laryngeal cancer and its precursor lesions

TY - JOUR

T1 - Value of fluorescence endoscopy for the early diagnosis of laryngeal cancer and its precursor lesions

AU - Kraft, Marcel

AU - Betz, Christian Stephan

AU - Leunig, Andreas

AU - Arens, Christoph

N1 - Copyright © 2010 Wiley Periodicals, Inc.

PY - 2011/7

Y1 - 2011/7

N2 - BACKGROUND: Fluorescence endoscopy is used for the early detection and delineation of laryngeal cancer and its precursor lesions. No systematic review of these promising imaging techniques has yet been performed.METHODS: A systematic review of the published literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1000 laryngeal lesions were examined by autofluorescence endoscopy (AFE), 318 mucosal changes by induced fluorescence endoscopy (IFE), and 679 laryngeal pathologies underwent normal white light endoscopy (WLE).RESULTS: In identifying precancerous and cancerous lesions of the larynx, sensitivity (91% vs 73%), specificity (84% vs 79%), and accuracy (88% vs 77%) of AFE were superior to WLE alone, whereas IFE showed an even higher sensitivity (95% vs 73%) at the expense of specificity (62% vs 79%). Therefore, AFE also achieved a higher specificity (84% vs 62%) and accuracy (88% vs 76%) than did IFE in detecting these kinds of lesions. However, the sensitivity (91% vs 95%) did not differ significantly between both methods.CONCLUSIONS: This meta-analysis confirms that fluorescence endoscopy is highly effective in the early diagnosis of laryngeal cancer and its precursor lesions. Thus, AFE can be used immediately without drug administration or possible side effects, whereas IFE is more suited for the detection of recurrent disease following initial surgery.

AB - BACKGROUND: Fluorescence endoscopy is used for the early detection and delineation of laryngeal cancer and its precursor lesions. No systematic review of these promising imaging techniques has yet been performed.METHODS: A systematic review of the published literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1000 laryngeal lesions were examined by autofluorescence endoscopy (AFE), 318 mucosal changes by induced fluorescence endoscopy (IFE), and 679 laryngeal pathologies underwent normal white light endoscopy (WLE).RESULTS: In identifying precancerous and cancerous lesions of the larynx, sensitivity (91% vs 73%), specificity (84% vs 79%), and accuracy (88% vs 77%) of AFE were superior to WLE alone, whereas IFE showed an even higher sensitivity (95% vs 73%) at the expense of specificity (62% vs 79%). Therefore, AFE also achieved a higher specificity (84% vs 62%) and accuracy (88% vs 76%) than did IFE in detecting these kinds of lesions. However, the sensitivity (91% vs 95%) did not differ significantly between both methods.CONCLUSIONS: This meta-analysis confirms that fluorescence endoscopy is highly effective in the early diagnosis of laryngeal cancer and its precursor lesions. Thus, AFE can be used immediately without drug administration or possible side effects, whereas IFE is more suited for the detection of recurrent disease following initial surgery.

KW - Aminolevulinic Acid

KW - Carcinoma, Squamous Cell

KW - Early Detection of Cancer

KW - Endoscopy

KW - Fluorescence

KW - Head and Neck Neoplasms

KW - Humans

KW - Laryngeal Neoplasms

KW - Laryngoscopy

KW - Photosensitizing Agents

KW - Precancerous Conditions

KW - Sensitivity and Specificity

KW - Journal Article

KW - Meta-Analysis

U2 - 10.1002/hed.21565

DO - 10.1002/hed.21565

M3 - SCORING: Journal article

C2 - 21674669

VL - 33

SP - 941

EP - 948

JO - HEAD NECK-J SCI SPEC

JF - HEAD NECK-J SCI SPEC

SN - 1043-3074

IS - 7

ER -