NGHIÊN CỨU ỨNG DỤNG NỘI SOI TIẾP XÚC TĂNG CƯỜNG TRONG CHẨN ĐOÁN CÁC KHỐI U THANH QUẢN GIAI ĐOẠN TIỀN UNG THƯ VÀ UNG THƯ TẠI BỆNH VIỆN TAI MŨI HỌNG TRUNG ƯƠNG

Abstract

 OF VIETNAM

Objective: The study aims to describe the clinical characteristics and compare the findings from standard endoscopy, enhanced contact endoscopy, and histopathological results of precancerous and cancerous laryngeal lesions at the National Otorhinolaryngology Hospital from 2023 to 2024. Subjects and Methods: A descriptive study was conducted on 61 patients with confirmed laryngeal tumors at the Oncology Center of the National Otorhinolaryngology Hospital of Vietnam from August 2023 to September 2024. Among these, 3 patients could not undergo enhanced contact endoscopy due to pseudomembrane, difficult posture, or bleeding. Therefore, 58 patients were included in the analysis. Results: All participants were male, with a mean age of 61.6 ± 8.1 years. The primary reason for seeking medical attention was hoarseness. Most patients presented for evaluation within 3 to 6 months of symptom onset (39.7%), followed by 1 to 3 months (27.6%). The exophytic type was the most common, accounting for 91.4% of cases. Tumors located at the glottic were the most frequent, with a prevalence of 65.5%. The proportion of patients with normal and paresis vocal cord mobility was 65.5% and 27.6%, respectively.  Standard endoscopy primarily evaluates tumor characteristics based on mucosal ulcer and the spread across laryngeal levels, often in a subjective manner without quantification.  In some cases, it was not possible to assess the full extent of the lesion or predict its benign or malignant nature. However, enhanced contact endoscopy identified 17 cases of leukoplakia classified as type 2 and 3 structures, while 41/58 cases identified as type 4 were diagnosed as squamous cell carcinoma on histopathology. Furthermore, cases classified as type 1, including polypoid and inflammatory lesions in the control group, were objectively evaluated according to Puxeddu et al.'s classification, which identified neovascular structures in laryngeal-hypopharyngeal tumors during enhanced contact endoscopy. The accuracy in the differential diagnosis between normal tissue and leukoplakia, and carcinoma of 100%. Conclusion: Enhanced contact endoscopy aids in predicting histological changes in precancerous and cancerous laryngeal lesions based on imaging and vascular structure. This technique is crucial for the diagnosis, treatment, and follow-up of patients with precancerous and cancerous laryngeal conditions.