窄带成像技术在门诊检查中对头颈部鳞状细胞癌的诊断及癌前病变随访的应用价值
Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions.
作者信息
Vilaseca Isabel, Valls-Mateus Meritxell, Nogués Anna, Lehrer Eduardo, López-Chacón Mauricio, Avilés-Jurado Francesc Xavier, Blanch José Luis, Bernal-Sprekelsen Manuel
机构信息
Otorhinolaryngology Department, Hospital Clinic, Barcelona, Spain.
ENT Surgical Oncology Section, Hospital Clinic, Barcelona, Spain.
出版信息
Head Neck. 2017 Sep;39(9):1854-1863. doi: 10.1002/hed.24849. Epub 2017 Jun 22.
BACKGROUND
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.
METHODS
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.
RESULTS
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).
CONCLUSION
The NBI provided a greater accuracy than WLE and showed promising usefulness for the follow-up of premalignant lesions.
背景
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。
方法
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。
结果
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）。
结论
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。
Zotero 插件