Department of Otolaryngology, Hospital Clínic, Barcelona, Spain.
Ear, Nose, and Throat Surgical Oncology Section, Hospital Clínic, Barcelona, Spain.
Head Neck. 2018 Jun;40(6):1164-1173. doi: 10.1002/hed.25088. Epub 2018 Jan 31.
The accuracy of white light endoscopy in combination with narrow band imaging (WLE + NBI) for diagnosis of squamous cell carcinoma (SCC) does not reach 100%. We evaluated the characteristics of the false-negative and false-positive cases.
Five hundred thirty lesions of the upper airways were evaluated. The WLE was followed by NBI examination before performing a biopsy.
The false-negative lesions (7.36%) were represented by submucosal and non-SCC tumors. Among the 25 non-SCC tumors, 72% did not show any suspicious vascular pattern under NBI. The false-positive lesions (6.04%) were mainly represented by postradiotherapy mucosal changes, ulcers, and infections. Regarding papillomas, NBI accuracy reached 95.32%, although cases with dysplasia were difficult to distinguish from SCC.
The WLE + NBI improved diagnostic accuracy, but not all lesions were ideally evaluated with current defined patterns. An accurate anamnesis is mandatory, because, in some cases, it may be more relevant than the NBI pattern.
白光内镜联合窄带成像（WLE+NBI）诊断鳞状细胞癌（SCC）的准确率未达到 100%。我们评估了假阴性和假阳性病例的特征。
评估了 530 个上呼吸道病变。在进行活检之前，先进行 WLE 检查，然后进行 NBI 检查。
假阴性病变（7.36%）表现为黏膜下和非 SCC 肿瘤。在 25 个非 SCC 肿瘤中，72%的肿瘤在 NBI 下没有显示出任何可疑的血管模式。假阳性病变（6.04%）主要表现为放疗后黏膜改变、溃疡和感染。对于乳头状瘤，NBI 准确率达到 95.32%，尽管有异型增生的病例难以与 SCC 区分。
WLE+NBI 提高了诊断准确率，但并非所有病变都能通过目前定义的模式进行理想评估。准确的病史是必要的，因为在某些情况下，它可能比 NBI 模式更重要。
