PDF(Pubmed)
Abstract：
BACKGROUND: This systematic review investigates techniques for determining adequate mucosal margins during the resection of oral squamous cell carcinoma (SCC). The primary treatment involves surgical removal with ≥5 mm margins, highlighting the importance of accurate differentiation between SCC and dysplasia during surgery.
METHODS: A comprehensive Embase and PubMed literature search was performed. Studies underwent quality assessment using QUADAS-2.
RESULTS: After the full-text screening and exclusion of studies exhibiting high bias, eight studies were included, focusing on three margin visualization techniques: autofluorescence, iodine staining, and narrow-band imaging (NBI). Negative predictive value (NPV) was calculable across the studies, though reference standards varied. Results indicated NPVs for autofluorescence, iodine, and NBI ranging from 61% to 100%, 92% to 99%, and 86% to 100%, respectively. Autofluorescence did not significantly enhance margins compared to white light-guided surgery, while iodine staining demonstrated improvement for mild or moderate dysplasia. NBI lacked comparison with a white light-guided surgery cohort.
CONCLUSIONS: We recommend studying and comparing the diagnostic accuracy of iodine staining and NBI in larger cohorts of patients with oral SCC, focusing on discriminating between SCC and (severe) dysplasia. Furthermore, we advise reporting the diagnostic accuracy alongside the treatment effects to improve the assessment of these techniques.
METHODS: A comprehensive Embase and PubMed literature search was performed. Studies underwent quality assessment using QUADAS-2.
RESULTS: After the full-text screening and exclusion of studies exhibiting high bias, eight studies were included, focusing on three margin visualization techniques: autofluorescence, iodine staining, and narrow-band imaging (NBI). Negative predictive value (NPV) was calculable across the studies, though reference standards varied. Results indicated NPVs for autofluorescence, iodine, and NBI ranging from 61% to 100%, 92% to 99%, and 86% to 100%, respectively. Autofluorescence did not significantly enhance margins compared to white light-guided surgery, while iodine staining demonstrated improvement for mild or moderate dysplasia. NBI lacked comparison with a white light-guided surgery cohort.
CONCLUSIONS: We recommend studying and comparing the diagnostic accuracy of iodine staining and NBI in larger cohorts of patients with oral SCC, focusing on discriminating between SCC and (severe) dysplasia. Furthermore, we advise reporting the diagnostic accuracy alongside the treatment effects to improve the assessment of these techniques.
摘要：
背景：本系统综述研究了确定口腔鳞状细胞癌（SCC）切除过程中适当粘膜边缘的技术。主要治疗包括手术切除边缘≥5mm，强调在手术过程中准确区分SCC和发育不良的重要性。
方法：进行了全面的Embase和PubMed文献检索。研究使用QUADAS-2进行质量评估。
结果：在全文筛选和排除具有高偏倚的研究之后，包括八项研究，专注于三种边缘可视化技术：自发荧光，碘染色,窄带成像（NBI）。阴性预测值(NPV)在所有研究中都是可以计算的，尽管参考标准各不相同。结果表明NPV为自发荧光，碘，NBI从61%到100%不等，92%到99%，86%到100%，分别。与白光引导手术相比，自体荧光并没有显着增强边缘，而碘染色显示轻度或中度发育不良的改善。NBI缺乏与白光引导手术队列的比较。
结论：我们建议在较大的口服SCC患者队列中研究和比较碘染色和NBI的诊断准确性，重点区分SCC和（严重）发育不良。此外，我们建议报告诊断准确性以及治疗效果,以改善对这些技术的评估.
方法：进行了全面的Embase和PubMed文献检索。研究使用QUADAS-2进行质量评估。
结果：在全文筛选和排除具有高偏倚的研究之后，包括八项研究，专注于三种边缘可视化技术：自发荧光，碘染色,窄带成像（NBI）。阴性预测值(NPV)在所有研究中都是可以计算的，尽管参考标准各不相同。结果表明NPV为自发荧光，碘，NBI从61%到100%不等，92%到99%，86%到100%，分别。与白光引导手术相比，自体荧光并没有显着增强边缘，而碘染色显示轻度或中度发育不良的改善。NBI缺乏与白光引导手术队列的比较。
结论：我们建议在较大的口服SCC患者队列中研究和比较碘染色和NBI的诊断准确性，重点区分SCC和（严重）发育不良。此外，我们建议报告诊断准确性以及治疗效果,以改善对这些技术的评估.
