Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Chiayi and the Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Pu-Tzu City, Chiayi County, Taiwan.
Laryngoscope. 2011 May;121(5):965-70. doi: 10.1002/lary.21719.
OBJECTIVES/HYPOTHESIS: To investigate the use of narrow-band imaging (NBI) endoscopy to detect the appearance of a light crest (LC) on the epithelial surface of the nasopharyngeal mucosa, which is suggested to be a distinctive endoscopic finding associated with the presence of adenoid hypertrophy.
Cross-sectional study.
A total of 79 consecutive adults with a high suspicion of malignancy underwent NBI endoscopy and nasopharyngeal biopsy to validate the diagnostic accuracy of the novel endoscopic technique. The degree of correlation between the LC grading and the histologic examinations of lymphoid hyperplasia, including the number of mucin-producing cells and lymphoid follicles, was then assessed.
The appearance of an LC on NBI endoscopy correlated with the histologic evidence of lymphoid hyperplasia with a sensitivity of 92.1%, a specificity of 95.1%, a positive predictive value of 94.6%, a negative predictive value of 92.9%, a false-positive value of 4.9%, a false-negative value of 7.9%, and an accuracy of 93.7%. The screening performance of NBI endoscopy for the presence of adenoid hypertrophy is significantly superior to that of conventional endoscopy (P = .0003). The LC grading was significantly correlated with the number of mucin-producing cells and lymphoid follicles (P < .001).
In NBI endoscopy, observation of an LC on the epithelial surface of the nasopharyngeal mucosa is a highly accurate predictor of the presence of adenoid hypertrophy.
目的/假设：研究窄带成像（NBI）内镜检测鼻咽黏膜上皮表面出现光嵴（LC）的情况，这被认为是与腺样体肥大存在相关的独特内镜表现。
横断面研究。
共 79 例高度怀疑恶性肿瘤的连续成人患者接受 NBI 内镜和鼻咽活检，以验证新内镜技术的诊断准确性。然后评估 LC 分级与淋巴组织增生的组织学检查之间的相关性，包括粘蛋白产生细胞和淋巴滤泡的数量。
NBI 内镜上 LC 的出现与淋巴组织增生的组织学证据相关，具有 92.1%的敏感性、95.1%的特异性、94.6%的阳性预测值、92.9%的阴性预测值、4.9%的假阳性值、7.9%的假阴性值和 93.7%的准确率。NBI 内镜筛查腺样体肥大的性能明显优于传统内镜（P =.0003）。LC 分级与粘蛋白产生细胞和淋巴滤泡的数量显著相关（P <.001）。
在 NBI 内镜中，观察鼻咽黏膜上皮表面的 LC 是腺样体肥大存在的高度准确预测指标。
