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Head Neck. 2015 Oct;37(10):1483-7. doi: 10.1002/hed.23781. Epub 2014 Oct 29.

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

Author information

1
Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
2
Facultad de Medicina, Universidad San Sebastián, Puerto Montt, Chile.
3
Pathology Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
4
CIBERESP, IRYCIS Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.

Abstract

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.

KEYWORDS:

ambulatory surgical procedures; biopsy; cost-benefit analysis; cytology; head and neck neoplasms

PMID:
24889909
DOI:
10.1002/hed.23781
[Indexed for MEDLINE]

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