Úvod: Díky mamografickému screeningu a zlepšování diagnostiky karcinomu prsu narůstá také záchyt prekanceróz. Jsou definovány jako morfologické změny mléčné žlázy, u kterých je vyšší pravděpodobnost vzniku karcinomu. Hodnocené prekancerózy jsou atypická duktální hyperplazie (ADH), lobulární karcinom in situ (LCIS) a radiální jizva. Metodika: V období 1. 1. 2018–31. 12. 2022 jsme na Chirurgické klinice FN Plzeň provedli 1 302 plánovaných operací pro onemocnění prsu, z toho 30 operací prekanceróz (2 %). O ADH se jednalo 11×, 8× o LCIS, 11× o radiální jizvu. Průměrný věk pacientek byl ve všech třech skupinách 56 let (27–85). Prekanceróza byla diagnostikována 8× pouze sonograficky, 3× mamograficky a 19× kombinací obou metod. Následně byla vždy doplněna punkční biopsie. Excizi tumoru s peroperační biopsií jsme provedli 28×, 2× mastektomii. Výsledky: V případě ADH z punkční biopsie se peroperačně potvrdila 8× ADH, 2× byl diagnostikován duktální karcinom in situ (ductal carcinoma in situ – DCIS), 1× mucinózní karcinom. U LCIS nebyl peroperační biopsií 4× tumor nalezen, 1× potvrzen LCIS, 1× diagnostikován lobulární invazivní karcinom, 2× provedena mastektomie bez peroperační biopsie. U radiální jizvy 3× diagnostikována ADH, 6× sklerozující adenóza, 1× DCIS, 1× invazivní karcinom. Po definitivním histologickém zpracování vzorků došlo ještě k nárůstu diagnostikovaných karcinomů. U ADH 3× DCIS, 2× DIC, 1× mucinózní karcinom. U LCIS 3× LIC. U radiální jizvy zůstává 1× DCIS a 1× invazivní karcinom. Tedy u 11 pacientek (37 %) byl díky operačnímu řešení diagnostikován karcinom. U žádné pacientky nebyla provedena operace axilárních uzlin. Všech 11 pacientek následně podstoupilo onkologickou léčbu, vždy kombinace radioterapie a hormonální terapie. Všechny pacientky žijí, 10 pacientek je v kompletní remisi onemocnění, u jedné s DCIS došlo po 4 letech k lokální recidivě. Závěr: Chirurgická léčba prekanceróz prsu má smysl, často se vedle prekancerózy skrývá už DCIS, či dokonce invazivní karcinom. Díky operačnímu řešení došlo k odhalení nádorového onemocnění včas.

Introduction: Thanks to mammographic screening and the improvement of breast cancer diagnostics, the detection of precancers is also increasing. They are defined as morphological changes of the mammary gland which are more likely to cause cancer. The evaluated precancers are atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS) and radial scar. Methodology: In the period 1. 1. 2018–31. 12. 2022, we performed 1,302 planned operations for breast disease at the Surgical Clinic of Teaching Hospital Plzeň, of which 30 (2%) were precancer operations. ADH was confirmed 11×, LCIS 8×, and a radical scar 11×. The average age of the patients in all three groups was 56 years (27–85). Precancer was diagnosed 8× only by sonography, 3× by mammography and 19× by a combination of both methods. Subsequently, a puncture biopsy was always completed. We performed 28 tumor excisions with intraoperative biopsy and 2 mastectomies. Results: In the case of ADH from puncture biopsy, ADH was confirmed intraoperatively 8×, DCIS was diagnosed 2×, and mucinous carcinoma 1×. In LCIS, no tumor was found by intraoperative biopsy 4×, LCIS was confirmed 1×, lobular invasive carcinoma was diagnosed 1×, mastectomy was performed 2× without intraoperative biopsy. In the radial scar, ADH was diagnosed 3×, sclerosing adenosis 6×, DCIS 1×, invasive carcinoma 1×. After the final histological processing of the samples, there was an increase in diagnosed carcinomas. In ADH, DCIS was confirmed 3×, DIC 2×, and mucinous carcinoma 1×. In LCIS, LIC was diagnosed 3×. In the radial scar, DCIS was confirmed 1×, and invasive carcinoma remain 1×. Thus, carcinoma was diagnosed in 11 patients (37%) thanks to the surgical solution. No patient underwent axillary node surgery. All 11 patients subsequently underwent oncological treatment, always a combination of radiotherapy and hormone therapy. All patients are alive, 10 patients are in complete remission of the disease, one with DCIS experienced a local recurrence after 4 years. Conclusion: Surgical treatment of precancers of the breast makes sense, DCIS or even invasive cancer is often hidden in addition to precancer. Thanks to the surgical solution, the cancer was detected in time.

• MeSH
• Adult MeSH
• Carcinoma, Intraductal, Noninfiltrating surgery   diagnostic imaging   pathology   MeSH
• Breast Carcinoma In Situ surgery   diagnostic imaging   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Mammography MeSH
• Breast Neoplasms * surgery   diagnostic imaging   pathology   MeSH
• Precancerous Conditions * surgery   diagnostic imaging   pathology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: Narrow Band Imaging (NBI) is an endoscopic optical imaging enhancement technology that improves the contrast of mucosal surface texture and enhances visualization of mucosal and submucosal vasculature. Due to its properties, it can visualize suspected malignant or precancerous lesions earlier than conventional white light endoscopy. The aim of this study was to analyze the benefit of NBI in visualization of precancerous and malignant lesions in preoperative and intraoperative diagnostics and correlation with histopathologic results. METHODS: A total of 589 patients with suspicious laryngeal or hypopharyngeal lesion were investigated using conventional white light endoscopy (WLE) and NBI endoscopy with high-definition TV (HDTV NBI) from 10/2013 to 12/2019. Patients were divided into two groups based on pre-operative NBI examination (group A, 345 patients) and intraoperative NBI examination (group B, 244 patients). All suspicious lesions were graded to 5 types of Ni classification and correlated with histopathologic results. The SPSS version 8.0.4 statistical software package was used for statistical analysis. In diagnosing premalignant and malignant lesions sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: The agreement between NBI endoscopy and histopathological analysis in group A was statistically significant (Қ = 0.76, p < 0.001), with a sensitivity of 86.2% (95% IS: 65.4-95.2) and specificity of 90.9% (95% IS: 70.6-94.1). Moreover, in group B was proven almost perfect agreement between NBI and histopathological analysis (Қ = 0.8461, p < 0.001), with a sensitivity of 84.0% (95% IS: 60.2-92.4) and specificity of 96.0% (95% IS: 87.0-99.2). CONCLUSIONS: Based on our results, NBI using the Ni classification has great potential in improving diagnosis of precancerous and malignant lesions and correlates strongly with histopathologic results. It serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal and hypopharyngeal lesions, especially using HDTV NBI.

• MeSH
• Diagnosis, Differential MeSH
• Adult MeSH
• Hypopharynx diagnostic imaging   MeSH
• Laryngoscopy MeSH
• Middle Aged MeSH
• Humans MeSH
• Pharyngeal Neoplasms diagnostic imaging   MeSH
• Laryngeal Neoplasms diagnostic imaging   MeSH
• Pharyngeal Diseases diagnostic imaging   MeSH
• Laryngeal Diseases diagnostic imaging   MeSH
• Predictive Value of Tests MeSH
• Precancerous Conditions diagnostic imaging   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• Narrow Band Imaging methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Acne Vulgaris drug therapy   MeSH
• Keratosis, Actinic therapy   MeSH
• Neoplasms, Basal Cell etiology   pathology   therapy   MeSH
• COVID-19 complications   MeSH
• Edema etiology   MeSH
• Erythema diagnosis   drug therapy   MeSH
• Nevus, Sebaceous of Jadassohn epidemiology   therapy   MeSH
• Acne Keloid drug therapy   MeSH
• Congresses as Topic MeSH
• Humans MeSH
• Facial Dermatoses diagnosis   classification   MeSH
• Skin Care methods   MeSH
• Precancerous Conditions diagnostic imaging   classification   MeSH
• Rosacea diagnosis   drug therapy   MeSH
• Oral Manifestations MeSH
• Check Tag
• Humans MeSH

• MeSH
• Cytodiagnosis methods   MeSH
• Papillomavirus Infections diagnosis   MeSH
• Humans MeSH
• Uterine Cervical Neoplasms * epidemiology   pathology   prevention & control   virology   MeSH
• Papillomaviridae isolation & purification   pathogenicity   MeSH
• Precancerous Conditions diagnostic imaging   pathology   MeSH
• Primary Prevention MeSH
• Secondary Prevention methods   MeSH
• Papillomavirus Vaccines pharmacology   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Female MeSH

• MeSH
• Vascular Malformations classification   MeSH
• Hemangioma classification   MeSH
• Carcinoma diagnostic imaging   classification   MeSH
• Humans MeSH
• Lymphoma diagnostic imaging   classification   MeSH
• Neoplasms, Glandular and Epithelial * diagnostic imaging   classification   MeSH
• Head and Neck Neoplasms * diagnostic imaging   classification   MeSH
• Odontogenic Tumors diagnostic imaging   classification   MeSH
• Precancerous Conditions diagnostic imaging   classification   MeSH
• Carcinoma, Squamous Cell MeSH
• Vascular Neoplasms classification   MeSH
• Check Tag
• Humans MeSH

Barrettův jícen je závažnou komplikací refluxní choroby jícnu. Jedná se o prekancerózu s rizikem vzniku adenokarcinomu jícnu, malignity s nepříznivou prognózou a narůstající incidencí. Důležitou roli v diagnostice a terapii Barrettova jícnu hraje endoskopie. Pokročilé zobrazovací metody umožňují detekci dysplazie a časného karcinomu, které lze úspěšně řešit endoskopicky a vyhnout se tak operačnímu řešení. Metodou volby léčby makroskopicky patrných lézí je endoskopická resekce, která současně představuje lokální stagingovou proceduru. Pacienti s dysplazií bez viditelné léze, nebo pacienti po endoskopické resekci jsou indikováni k ablační terapii.

Barrett esophagus is a severe complication of gastroesophageal reflux disease and precursor of esophageal adenocarcinoma. Endoscopy plays a key role in diagnosis and therapy of Barrett esophagus. Advances in endoscopic technology offer possibility to detect dysplasia and early neoplasia, that can be treated by means of endoscopy in order to avoid surgery. Endoscopic resection is a method of choice in case of a visible neoplastic lesion and it represents an optimal local staging procedure. Patients with dysplasia and no visible lesion, or patients after endoscopic resection are indicated to ablative therapy.

• MeSH
• Adenocarcinoma diagnosis   surgery   therapy   MeSH
• Barrett Esophagus * diagnostic imaging   diagnosis   therapy   MeSH
• Esophagoscopy * methods   MeSH
• Catheter Ablation MeSH
• Humans MeSH
• Esophageal Neoplasms * diagnosis   surgery   therapy   MeSH
• Precancerous Conditions diagnostic imaging   MeSH
• Check Tag
• Humans MeSH