Vilaseca Isabel, Valls-Mateus Meritxell, Nogués Anna, Lehrer Eduardo, López-Chacón Mauricio, Avilés-Jurado Francesc Xavier, Blanch José Luis, Bernal-Sprekelsen Manuel
Otorhinolaryngology Department, Hospital Clinic, Barcelona, Spain.
ENT Surgical Oncology Section, Hospital Clinic, Barcelona, Spain.
Head Neck. 2017 Sep;39(9):1854-1863. doi: 10.1002/hed.24849. Epub 2017 Jun 22.
The purpose of this study was to evaluate the value of narrow band imaging (NBI) examination in the office for the diagnosis and follow-up of upper airway premalignant and malignant lesions.
Four hundred eighty lesions were evaluated with white light endoscopy (WLE) and NBI before a biopsy/excision. Additionally, 151 premalignant lesions were followed up without proven biopsy. Carcinoma-free survival was calculated. The learning curve was analyzed.
Overall, the accuracy improved from 74.1% with WLE to 88.9% with NBI, being relevant in all anatomic subsites. The accuracy of NBI increased significantly with increasing experience (area under the curve [AUC] >0.9). After a follow-up of 25 months, 14 of 151 lesions (9.3%) converted into carcinoma. The 4-year carcinoma-free survival rate was 86.4%. The 4-year carcinoma-free survival rate differed significantly between lesions classified as benign/mild dysplasia versus those presenting as moderate/severe dysplasia (88.9% vs 73.5%; P = .018).
The NBI provided a greater accuracy than WLE and showed promising usefulness for the follow-up of premalignant lesions.
本研究的目的是评估诊室窄带成像（NBI）检查在上气道癌前病变和恶性病变诊断及随访中的价值。
在活检/切除前，用白光内镜（WLE）和NBI对480个病变进行评估。此外，对151个癌前病变进行了未经验证活检的随访。计算无癌生存率。分析学习曲线。
总体而言，准确率从WLE的74.1%提高到NBI的88.9%，在所有解剖亚部位均有相关性。随着经验的增加，NBI的准确率显著提高（曲线下面积[AUC]>0.9）。随访25个月后，151个病变中有14个（9.3%）转变为癌。4年无癌生存率为86.4%。分类为良性/轻度发育异常的病变与中度/重度发育异常的病变的4年无癌生存率有显著差异（88.9%对73.5%；P = 0.018）。
NBI比WLE具有更高的准确率，且在癌前病变的随访中显示出有前景的实用性。
