title: Use of endoscopy with narrow-band imaging system in detecting squamous cell carcinoma in oral chronic non-healing ulcers.
abstract: OBJECTIVE
  This study seeks to analyze the factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers for more than 3 weeks and investigate the role of endoscopy with narrow-band imaging system (NBI) in detecting carcinoma in these lesions.
  
  
  METHODS
  The demographic and clinicopathological data of patients receiving surgical interventions for chronic oral non-healing ulcers, and the intraepithelial papillary capillary loop patterns shown by NBI were retrospectively reviewed and analyzed.
  
  
  RESULTS
  A total of 63 patients (41 males and 22 females) with mean age of 57.9 ± 16.7 years were enrolled. In univariate analysis, ulcers with induration, history of oral cancer, and intraepithelial microvasculature of NBI were factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers. Multivariate analysis showed that the intraepithelial microvasculature of NBI was the only independent factor predicting the occurrence of carcinoma in oral chronic non-healing ulcers with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.75 %, 91.49 %, 78.95 %, 97.73 %, and 92.06 %, respectively.
  
  
  CONCLUSIONS
  Morphology of intraepithelial microvasculature of NBI, or twisted, elongated, and destructive pattern of intraepithelial papillary capillary loop, is the only independent factor associated with the occurrence of squamous cell carcinoma in oral chronic non-healing ulcers. Endoscope with NBI is a rapid, safe, and promising tool in detecting squamous cell carcinoma in oral chronic non-healing ulcers.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, No. 222, Mai Chin Road, Keelung 204, Taiwan, Republic of China, sweeyang@gmail.com.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Yun-Shien
authors.initials: YS
authors.lastname: Lee
authors.forename: Liang-Che
authors.initials: LC
authors.lastname: Chang
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Hwang
authors.forename: Tai-An
authors.initials: TA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D019226:Oral Ulcer / Q000503:physiopathology*; D055815:Young Adult