In-office cup biopsy and laryngeal cytology versus operating room biopsy for the diagnosis of pharyngolaryngeal tumors: Efficacy and cost-effectiveness.

Autor: Castillo Farías F; Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.; Facultad de Medicina, Universidad San Sebastián, Puerto Montt, Chile., Cobeta I; Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain., Souviron R; Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain., Barberá R; Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain., Mora E; Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain., Benito A; Pathology Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain., Royuela A; CIBERESP, IRYCIS Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2015 Oct; Vol. 37 (10), pp. 1483-7. Date of Electronic Publication: 2014 Oct 29.
DOI: 10.1002/hed.23781
Abstrakt: Background: In-office biopsy is an effective technique to diagnose the nature of pharyngolaryngeal lesions.
Methods: We selected patients with pharyngolaryngeal lesions suspicious for malignancy. For in-office biopsy procedures, laryngeal cytology and direct laryngoscopy biopsy were performed, and diagnostic parameters and costs were estimated.
Results: Eighty-eight patients were selected for this study. For laryngeal cytology, sensitivity was 70.3% (95% confidence interval [CI] = 59.9% to 80.7%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 50% (95% CI = 35.2% to 64.8%). In-office biopsy sensitivity was 81% (95% CI = 72.6% to 89.3%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 20% (95% CI = 2.5% to 37.5%). At our hospital, the use of in-office biopsies as a first approach for diagnosis saves $50,140.80 U.S. per annum.
Conclusion: In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.
(© 2014 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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