Differences in Clinical Characteristics Between Missed and Detected Laryngopharyngeal Cancers.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yusuke Kumazawa, Yohei Ikenoyama, Manabu Takamatsu, Koyo Kido, Ken Namikawa, Yoshitaka Tokai, Shoichi Yoshimizu, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Akira Seto, Takashi Toshiyasu, Shunji Takahashi, Junko Fujisaki
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Abstract

Background and aim: Laryngopharyngeal cancers are often overlooked during endoscopy because of their anatomical complexity and the gag reflex. However, the characteristics of these cancers remain poorly understood. We studied the differences in clinical characteristics and endoscopic procedures between missed and detected cancers.

Methods: Newly diagnosed laryngopharyngeal squamous cell carcinomas identified during esophagogastroduodenoscopy at our hospital between January 2016 and December 2020 were analyzed. A total of 179 lesions were categorized into two groups: missed (n = 74) and detected (n = 105). Missed cancer was defined as a lesion identified within 18 months of preceding esophagogastroduodenoscopy at our hospital, while detected cancer was defined as a lesion not included in the missed group.

Results: The miss rate of laryngopharyngeal cancers on esophagogastroduodenoscopy was 41.3%. Multivariate analysis showed that the non-use rate of pethidine hydrochloride (odds ratio 4.1, 95% confidence interval 2.0-8.6, p < 0.01), ratio of white-light imaging ≥ narrow-band imaging through observation of laryngopharynx (odds ratio 31.8, 95% confidence interval 3.9-258.0, p < 0.01), and number of "comprehensiveness of laryngopharyngeal observation" negatives (odds ratio 2.6, 95% confidence interval 1.3-5.4, p = 0.01) were significantly larger in the missed group. Univariate analysis showed that the number of tumors located on the epiglottis (p = 0.02) was significantly larger in the missed group.

Conclusions: This study highlights the importance of precisely observing the laryngopharynx, facilitated by the use of pethidine hydrochloride and narrow-band imaging. In addition, epiglottic lesions are frequently missed. Comprehensive observation of the laryngopharynx using narrow-band imaging and premedication may reduce the frequency of missed cancers.

漏诊与发现喉咽癌临床特征的差异。
背景与目的:喉咽癌由于其解剖复杂性和呕吐反射,在内镜检查中经常被忽视。然而,这些癌症的特征仍然知之甚少。我们研究了漏诊和发现的癌症在临床特征和内镜检查过程中的差异。方法:对2016年1月至2020年12月我院食管胃十二指肠镜检查中发现的新诊断咽喉鳞状细胞癌进行分析。179个病灶分为两组:未发现(n = 74)和发现(n = 105)。漏诊癌定义为在我院进行食管胃十二指肠镜检查前18个月内发现的病变,而已发现的癌定义为未包括在漏诊组的病变。结果:食管胃十二指肠镜检查喉咽癌漏诊率为41.3%。多因素分析显示盐酸哌替啶不使用率(优势比4.1,95%可信区间2.0 ~ 8.6,p)。结论:本研究强调了精确观察喉咽的重要性,盐酸哌替啶的使用和窄带成像的使用为其提供了便利。此外,会厌病变经常被遗漏。采用窄带显像和预用药对喉咽部进行综合观察,可减少漏诊的频率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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