VELscope-Guided Surgery of an Early Stage Tongue Cancer-A Case Report

螢光目視法導引之初期舌癌切除－病例報告

呂佩軒(Pei-Hsuan Lu) ； 張玉芳(Julia Yu Fong Chang) ； 章浩宏(Hao-Hueng Chang)

《臺灣口腔顎面外科學會雜誌》 33卷2期 (2022/06) Pp. 137-145

摘要

Oral cancer is a global health issue and also a major public health concern in Taiwan. Risk habits including tobacco, alcohol and betel quid consumption are related to the high prevalence of oral cancer. Field cancerization contributes to frequent loco-regional recurrence and poor outcome. Efficient surgical excision of high grade dysplasia and early stage oral cancer play an important role to improve the prognosis. VELscope guided surgery has shown high sensitivity to assist oral surgeon for identifying the dysplastic epithelium, oral cancer, and oral mucosa with early cancer-associated genetic alterations. Here, we reported a case with long-term tobacco consumption for more than five decades and was diagnosed as left side stage I tongue cancer in our hospital. He underwent left side partial glossectomy with intra-operative VELscope guidance. The pathology report showed the excisional margins were uninvolved by carcinoma or high grade dysplasia. No local recurrence was noted in the 10 months follow-up visit.

關鍵字

VELscope ； Field cancerization

並列摘要

口腔癌是重要世界衛生議題，同時也是台灣公共衛生所關切的焦點。因為抽菸、喝酒、嚼檳榔等不良嗜好導致高盛行率與口腔區域癌化現象，後者又更進一步造成常見的局部復發與不良預後。有效且完全的切除高度上皮變異之癌前病變與初期的口腔癌，在口腔癌預後的改善扮演重要角色。近年來文獻顯示，使用自體螢光輔助設備，可以提高口腔外科醫師辨識口腔癌、癌前病變及具有口腔癌早期基因變異的口腔黏膜之敏感度。此病例為一老年男性有超過50年抽菸習慣，在台大醫院被診斷為第一期舌癌。之後在全身麻醉下接受螢光目視法導引之左側舌癌切除，術後病理報告顯示手術邊緣沒有癌細胞或高度上皮變異。病患於術後10個月的門診追蹤狀況良好，沒有復發跡象。

並列關鍵字

自體螢光輔助設備 ； 區域癌化