Systematic classification of confocal laser endomicroscopy for the diagnosis of oral cavity carcinoma

Sievert M, Oetter N, Mantsopoulos K, Gostian AO, Müller SK, Koch M, Balk M, Thimsen V, Stelzle F, Eckstein M, Iro H, Goncalves M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Oral Oncology Elsevier

Book Volume: 132

Article Number: 105978

DOI: 10.1016/j.oraloncology.2022.105978

Abstract

Introduction: Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo microscope-like images of the upper aerodigestive tract's mucosa in 1000-fold magnification. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignoma suspected mucosa requires strict evaluation criteria. This study aims to validate a score for oral cavity squamous cell carcinoma (OCSCC) diagnostic. Methods: We performed CLE and examined a total of twelve patients. All 95 sequences (778 s, 6224 images) originate from the area of the primary tumor 260 s, 2080 images) and unsuspicious mucosa of the oral cavity (518 s, 4144 images). Specimen were taken at corresponding locations and analyzed histologically in H&E staining as a reference standard. A total of eight examiners (four experienced and four inexperienced) evaluated the sequences based on a scoring system. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are inter-rater reliability and receiver operator characteristics. Results: Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 88.7 %, 90.1 %, 87.4 %, 87.5 %, and 90.0 %, respectively, with inter-rater reliability and κ-value of 0.775, and an area under the curve of 0.935. Conclusions: The results confirm that this scoring system is applicable in the oral cavity mucosa to classify benign and malignant tissue.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Nicolai Oetter Department of Oral and Cranio-Maxillofacial Surgery Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Antoniu-Oreste Gostian Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Michael Koch Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Matthias Balk Department of Otorhinolaryngology – Head and Neck Surgery Vivian Thimsen Department of Otorhinolaryngology – Head and Neck Surgery Florian Stelzle Department of Oral and Cranio-Maxillofacial Surgery Markus Eckstein Institute of Pathology Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde

Involved external institutions

Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen DE Germany (DE)

How to cite

APA:

Sievert, M., Oetter, N., Mantsopoulos, K., Gostian, A.-O., Müller, S.K., Koch, M.,... Goncalves, M. (2022). Systematic classification of confocal laser endomicroscopy for the diagnosis of oral cavity carcinoma. Oral Oncology, 132. https://doi.org/10.1016/j.oraloncology.2022.105978

MLA:

Sievert, Matti, et al. "Systematic classification of confocal laser endomicroscopy for the diagnosis of oral cavity carcinoma." Oral Oncology 132 (2022).

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