title: Enhanced contact endoscopy for the assessment of the neoangiogenetic changes in precancerous and cancerous lesions of the oral cavity and oropharynx.
abstract: Dysplasia and squamous cell carcinoma of the upper aerodigestive tract show significant neoangiogenesis appearing as subepithelial and epithelial microvascular irregularities that can be detected by Image-Enhanced Endoscopy such as Narrow Band Imaging and Storz Professional Image Enhancement System. In the present study, the most advanced endoscopic enhancement systems were coupled with Contact Endoscopy (Enhanced Contact Endoscopy). This original method improved the identification and the understanding of the neoangiogenetic changes of the chorion in 42 patients with leukoplakia, erythroplakia, and leuko-erythroplakia of the oral cavity and oropharynx. The physiologic and pathologic mucosa was described in five obvious vascular patterns observed at Enhanced Contact Endoscopy ranging from normal to squamous cell carcinoma, passing through inflammation, hyperplasia, and dysplasia. Each vascular pattern was then compared to histology, showing that the microvascular architectural changes seen with Enhanced Contact Endoscopy are almost constant. Sensitivity, specificity, positive predictive value, and negative predictive value in the differentiation between healthy mucosa and inflammation versus pathologic hyperplasia, dysplasia, and carcinoma were, respectively, 96.6, 93.3, 98.2, 87.5, and 95.9 %. Sensitivity and specificity were 100 % in differentiation between non-malignant lesions versus squamous cell carcinoma. Our preliminary experience shows that accuracy of Image-Enhanced Endoscopy in the diagnosis of precancerous lesions and squamous cell carcinoma of the oral cavity and oropharynx can be increased if associated to Contact Endoscopy.
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Azienda Ospedaliero-Universitaria, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. filippocarta@unica.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Carta
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Azienda Ospedaliero-Universitaria, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Sionis
authors.affiliation: Department of General Surgery, Maricopa Integrated Health System, 2601 E. Roosvelt Street, Phoenix, AZ, 85008, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cocco
authors.affiliation: Section of Pathology, Department of Surgery, School of Medicine, Azienda Ospedaliero-Universitaria, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Gerosa
authors.affiliation: M. Aresu Department of Medical Science - Section of Dermatology, School of Medicine, Azienda Ospedaliero-Universitaria, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Ferreli
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Azienda Ospedaliero-Universitaria, P.O. S Giovanni di Dio, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Puxeddu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis*; D009960:Oropharynx / Q000473:pathology*; D011230:Precancerous Conditions / Q000175:diagnosis*; D015203:Reproducibility of Results
keywords: Enhanced contact endoscopy; Head and neck cancer; NBI; Neoangiogenesis; Oral cavity; Oropharynx; SPIES