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Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superfi cial carcinoma

World Journal of Gastroenterology 2011年第45期17卷 4999-5006页

作者： Noboru Yoshimura Kenichi Goda Hisao Tajiri Yukinaga Yoshida Takakuni Kato Yoichi Seino Masahiro Ikegami Mitsuyoshi Urashima Department of Endoscopy The Jikei University School of Medicine Division of Gastroenterology and Hepatology Department of Internal Medicine The Jikei University School of Medicine Department of Otorhinolaryngology The Jikei University School of Medicine Department of Pathology The Jikei University School of Medicine Clinical Research and Development The Jikei University School of Medicine

AIM: To investigate the endoscopic features of pharyngeal superfi cial carcinoma and evaluate the utility of narrow-band imaging (NBI) for this disease. METHODS: In the present prospective study, 335 patients underwent conventional white light (CWL) en-doscopy and non-magnifi ed/magnifi ed NBI endoscopy, followed by an endoscopic biopsy, for 445 superfi cial lesions in the oropharynx and hypopharynx. The macroscopic appearance of superfi cial lesions was categorized as either elevated (< 5 mm in height), flat, or depressed (not ulcerous). Superficial carcinoma (SC) was defi ned as a superfi cial lesion showing high-grade dysplasia or squamous cell carcinoma on histology. The color, delineation, and macroscopic appearances of the lesions were evaluated by CWL endoscopy. The ratio of the brownish area/intervascular brownish epithelium (IBE), as well as microvascular proliferation, dilation, and irregularities, was determined by non-magnifi ed/ magnifi ed NBI endoscopy. An experienced pathologist who was unaware of the endoscopic fi ndings made the histological diagnoses. By comparing endoscopic fi ndings with histology, we determined the endoscopic features of SC and evaluated the diagnostic utility of NBI. RESULTS: The 445 lesions were divided histologically into two groups: a non-SC group, including non-neoplasia and low-grade dysplasia cases, and an SC group. Of the 445 lesions examined, 333 were classified as non-SC and 112 were classif ied as SC. There were no significant differences in age, gender, or the location of the lesions between the patients in the two groups. The mean diameter of the SC lesions was signif icantly greater than that of non-SC lesions (11.0 ± 7.6 mm vs 4.6 ± 3.6 mm, respectively, P < 0.001). Comparisons of CWL endoscopy fi ndings for SC and non-SC lesions by univariate analysis revealed that the incidence of redness (72% vs 41%, respectively, P < 0.001) and a flat or depressed type of lesion (58% vs 44%, respectively, P = 0.013) was signif

关键词： Narrow-band imaging Magnified endoscopy Endoscopic diagnosis Pharynx pharyngeal cancer Superfi cial carcinoma Squamous cell carcinoma Dysplasia

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In-vivo optical imaging in head and neck oncology: basic principles, clinical applications and future directions

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International Journal of Oral Science 2018年第1期10卷 14-26页

作者： Chenzhou Wu John Gleysteen Nutte Tarn Teraphongphom Yi Li Eben Rosenthal State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of StomatologySichuan University Department of Otolaryngology University of Tennessee Health Science Center Department of Otolaryngology and Radiology Stanford University

Head and neck cancers become a severe threat to human’s health nowadays and represent the sixth most common cancer worldwide. Surgery remains the first-line choice for head and neck cancer patients. Limited resectable tissue mass and complicated anatomy structures in the head and neck region put the surgeons in a dilemma between the extensive resection and a better quality of life for the patients. Early diagnosis and treatment of the pre-malignancies, as well as real-time in vivo detection of surgical margins during en bloc resection, could be leveraged to minimize the resection of normal tissues. With the understanding of the head and neck oncology, recent advances in optical hardware and reagents have provided unique opportunities for real-time pre-malignancies and cancer imaging in the clinic or operating room. Optical imaging in the head and neck has been reported using autofluorescence imaging, targeted fluorescence imaging, high-resolution microendoscopy, narrow band imaging and the Raman spectroscopy. In this study, we reviewed the basic theories and clinical applications of optical imaging for the diagnosis and treatment in the field of head and neck oncology with the goal of identifying limitations and facilitating future advancements in the field.

关键词： SQUAMOUS-CELL CARCINOMA ENHANCED RAMAN-SPECTROSCOPY HIGH-RESOLUTION MICROENDOSCOPY ORAL-cancer pharyngeal cancer AUTOFLUORESCENCE ENDOSCOPY FLUORESCENCE VISUALIZATION TISSUE AUTOFLUORESCENCE RESECTION MARGINS LARYNGEAL-cancer

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Recent traction methods for endoscopic submucosal dissection

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World Journal of Gastroenterology 2016年第26期22卷 5917-5926页

作者： Kunihiro Tsuji Naohiro Yoshida Hiroyoshi Nakanishi Kenichi Takemura Shinya Yamada Hisashi Doyama Department of Gastroenterology Ishikawa Prefectural Central Hospital

Endoscopic mucosal resection(EMR) is problematic with regard to en bloc and curable resection *** in endoscopic techniques have enabled novel endoscopic approaches such as endoscopic submucosal dissection(ESD), which has overcome some EMR problems, and has become the standard treatment for gastrointestinal tumors. However, ESD is technically difficult. Procedure time is longer and complications such as intraoperative perforation and bleeding occur more frequently than in EMR. Recently various traction methods have been introduced to facilitate ESD procedures, such as clip with line, external forceps, clip and snare, internal traction, double scope, and magnetic anchor. Each method must be used appropriately according to the anatomical characteristics. In this review we discuss recently proposed traction methods for ESD based on the characteristics of various anatomical sites.

关键词： Endoscopic submucosal dissection Traction pharyngeal cancer Esophageal cancer Gastric cancer Colorectal cancer

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