Yi Dong, Bing Zhou, Shunjiu Cui, Qian Huang, Yan Sun, Yunfu Liu, Xiaojin He, Huijun Han
{"title":"提高鼻腔自然杀伤细胞/T 细胞淋巴瘤早期检测率和活检阳性率的方法。","authors":"Yi Dong, Bing Zhou, Shunjiu Cui, Qian Huang, Yan Sun, Yunfu Liu, Xiaojin He, Huijun Han","doi":"10.1002/lary.31914","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To develop methods for early detection of natural killer/T-cell lymphoma, nasal type (nasal NKTL) and to evaluate the use of apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) for selecting biopsy sites to enhance the positive biopsy rate.</p><p><strong>Methods: </strong>The clinical data of 32 cases of nasal NKTL were retrospectively collected and analyzed. Cases were graded from 1 to 5 based on endoscopic and imaging findings. Biopsy methods included the superficial forceps method and deep incisional method. Data recorded included biopsy method, time to confirmed diagnosis, number of biopsies required, and ADC values of biopsy sites.</p><p><strong>Results: </strong>Both endoscopic and MRI lesion severity did not affect biopsy outcomes (p = 0.8248, 0.7571). The deep incisional biopsy method had a significantly higher probability of yielding positive pathological results compared to the superficial clamping method [OR (95% CI) = 23.2143 (6.0448, 89.1513) (χ<sup>2</sup> = 26.1089, p < 0.0001)]. The ADC value at the site with a positive biopsy result is significantly lower than at the site with a negative result (p = 0.0003). The diagnostic threshold for ADC value to predict a positive biopsy result was 0.603 × 10<sup>-3</sup> mm<sup>2</sup>/s, with a Youden index of 0.43.</p><p><strong>Conclusions: </strong>Nasal NKTL has distinct characteristics distinguishing it from sinusitis and other tumors. Deep incision biopsy under general anesthesia is superior to the superficial method. The location of the positive sampling site can be guided by measuring the ADC value, and the optimal diagnostic threshold of this proposed method is 0.603 × 10<sup>-3</sup> mm<sup>2</sup>/s.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 2024.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Approaches to Increase Early Detection and Positive Biopsy Rate of Nasal Natural Killer/T-Cell Lymphoma.\",\"authors\":\"Yi Dong, Bing Zhou, Shunjiu Cui, Qian Huang, Yan Sun, Yunfu Liu, Xiaojin He, Huijun Han\",\"doi\":\"10.1002/lary.31914\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To develop methods for early detection of natural killer/T-cell lymphoma, nasal type (nasal NKTL) and to evaluate the use of apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) for selecting biopsy sites to enhance the positive biopsy rate.</p><p><strong>Methods: </strong>The clinical data of 32 cases of nasal NKTL were retrospectively collected and analyzed. Cases were graded from 1 to 5 based on endoscopic and imaging findings. Biopsy methods included the superficial forceps method and deep incisional method. Data recorded included biopsy method, time to confirmed diagnosis, number of biopsies required, and ADC values of biopsy sites.</p><p><strong>Results: </strong>Both endoscopic and MRI lesion severity did not affect biopsy outcomes (p = 0.8248, 0.7571). The deep incisional biopsy method had a significantly higher probability of yielding positive pathological results compared to the superficial clamping method [OR (95% CI) = 23.2143 (6.0448, 89.1513) (χ<sup>2</sup> = 26.1089, p < 0.0001)]. The ADC value at the site with a positive biopsy result is significantly lower than at the site with a negative result (p = 0.0003). The diagnostic threshold for ADC value to predict a positive biopsy result was 0.603 × 10<sup>-3</sup> mm<sup>2</sup>/s, with a Youden index of 0.43.</p><p><strong>Conclusions: </strong>Nasal NKTL has distinct characteristics distinguishing it from sinusitis and other tumors. Deep incision biopsy under general anesthesia is superior to the superficial method. The location of the positive sampling site can be guided by measuring the ADC value, and the optimal diagnostic threshold of this proposed method is 0.603 × 10<sup>-3</sup> mm<sup>2</sup>/s.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 2024.</p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-11-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.31914\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.31914","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Approaches to Increase Early Detection and Positive Biopsy Rate of Nasal Natural Killer/T-Cell Lymphoma.
Objectives: To develop methods for early detection of natural killer/T-cell lymphoma, nasal type (nasal NKTL) and to evaluate the use of apparent diffusion coefficient (ADC) measurements from diffusion-weighted imaging (DWI) for selecting biopsy sites to enhance the positive biopsy rate.
Methods: The clinical data of 32 cases of nasal NKTL were retrospectively collected and analyzed. Cases were graded from 1 to 5 based on endoscopic and imaging findings. Biopsy methods included the superficial forceps method and deep incisional method. Data recorded included biopsy method, time to confirmed diagnosis, number of biopsies required, and ADC values of biopsy sites.
Results: Both endoscopic and MRI lesion severity did not affect biopsy outcomes (p = 0.8248, 0.7571). The deep incisional biopsy method had a significantly higher probability of yielding positive pathological results compared to the superficial clamping method [OR (95% CI) = 23.2143 (6.0448, 89.1513) (χ2 = 26.1089, p < 0.0001)]. The ADC value at the site with a positive biopsy result is significantly lower than at the site with a negative result (p = 0.0003). The diagnostic threshold for ADC value to predict a positive biopsy result was 0.603 × 10-3 mm2/s, with a Youden index of 0.43.
Conclusions: Nasal NKTL has distinct characteristics distinguishing it from sinusitis and other tumors. Deep incision biopsy under general anesthesia is superior to the superficial method. The location of the positive sampling site can be guided by measuring the ADC value, and the optimal diagnostic threshold of this proposed method is 0.603 × 10-3 mm2/s.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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