Endoscopic autofluorescence imaging in the diagnosis of premalignant lesions and laryngeal/hypopharyngeal cancer

Abstract

The purpose of the study was to assess the diagnostic value of endoscopic autofluorescence imaging (AFI) in patients with premalignant lesions and primary laryngeal/hypopharyngeal cancer.Material and Methods. The diagnostic value of AFI was assessed in 53 patients with chronic hyperplastic laryngeal/hypopharyngeal lesions and 48 patients with laryngeal/hypopharyngeal cancer.Results. The inclusion of video laryngoscopy with AFI in the algorithm for examining patients with chronic diseases of the upper respiratory tract made it possible to significantly improve the diagnostic efficacy of endoscopic examination in patients with premalignant lesions (high grade dysplasia) of the laryngeal mucosa. Video laryngoscopy with AFI was found to achieve higher sensitivity, specificity and accuracy rates than white light video laryngoscopy (87.5, 96.9 and 92.5 vs 50.0, 96.0 and 71.7 %, respectively, p<0.05). The video laryngoscopy with AFI allowed identification of not only pathological changes in the laryngeal and hypopharyngeal mucosa but also their malignant potential, as well as identification of areas for targeted biopsy. In 9 (18.8 %) laryngeal cancer patients, the standard white light video laryngoscopy demonstrated difficulties in the differential diagnosis of laryngeal cancer (n=4) and in assessing the extent of laryngeal cancer (n=5). In 3 out of 4 diagnostically difficult cases, video laryngoscopy with AFI made it possible to confirm the diagnosis of laryngeal cancer and in 5 cases to accurately determine the extent of hypopharyngeal cancer.Conclusion. The addition of standard videolaryngoscopy with a hightech technique of autofluorescence endoscopy makes it possible to accurately diagnose premalignant and malignant lesions of the larynx and hypopharynx.