title: Value of fluorescence endoscopy for the early diagnosis of laryngeal cancer and its precursor lesions.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland. marcel.kraft@gmx.ch
authors.forename: Marcel
authors.initials: M
authors.lastname: Kraft
authors.forename: Christian Stephan
authors.initials: CS
authors.lastname: Betz
authors.forename: Andreas
authors.initials: A
authors.lastname: Leunig
authors.forename: Christoph
authors.initials: C
authors.lastname: Arens
mesh_terms: D000622:Aminolevulinic Acid; D002294:Carcinoma, Squamous Cell; D055088:Early Detection of Cancer / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005453:Fluorescence; D006258:Head and Neck Neoplasms; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D007828:Laryngoscopy / Q000379:methods*; D017319:Photosensitizing Agents; D011230:Precancerous Conditions / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid