Otolaryngology Department, Warsaw Medical University, Warsaw, Poland.
Students Scientific Research Group by Otolaryngology Department, Warsaw Medical University, Warsaw, Poland.
Head Neck. 2018 Oct;40(10):2149-2154. doi: 10.1002/hed.25201. Epub 2018 May 13.
This study investigates relevance of narrow band imaging (NBI) in stratifying risk of malignant transformation within leukoplakia.
We conducted a prospective analysis that included 62 patients with 91 changes of leukoplakia on vocal folds. The NBI was obtained before microsurgery. Categorization of the lesion as benign was made when vessels of surrounding epithelium were classified as type I, II, or IV according to Ni classification. If there were visualized intraepithelial papillary capillary loops of type V, the lesion was classified as malignant. Results were compared to the histopathological diagnosis.
The NBI assessment classified 75 lesions (82.4%) as benign and 16 (17.6%) as malignant. Histopathological results revealed the diagnosis of no dysplastic changes or low grade dysplasia in 77 cases (84.6%). Another 14 cases (15.4%) occurred with high-grade dysplasia, carcinoma in situ, and invasive cancer. Sensitivity, specificity, and accuracy of NBI in predicting malignancy within leukoplakia were 100%, 97.4%, and 97.8%, respectively. The kappa index was 0.92 (95% confidence interval 81.1%-100%).
The noninvasive procedure of an NBI endoscopy may be recommended as an accurate method in predicting the risk of malignant transformation within the vocal fold leukoplakia and, therefore, would be useful in the clinic for planning the patient's therapy.
本研究旨在探讨窄带成像（NBI）在评估白斑恶性转化风险中的相关性。
我们进行了一项前瞻性分析，纳入了 62 例声带白斑患者的 91 处病变。在微创手术前进行 NBI 检查。根据 Ni 分类，当周围上皮的血管分为 I 型、II 型或 IV 型时，将病变归类为良性。如果观察到上皮内乳头状毛细血管环为 V 型，则将病变归类为恶性。将结果与组织病理学诊断进行比较。
NBI 评估将 75 处病变（82.4%）归类为良性，16 处病变（17.6%）归类为恶性。组织病理学结果显示 77 例（84.6%）无异型性改变或低级别异型增生。另外 14 例（15.4%）为高级别异型增生、原位癌和浸润性癌。NBI 预测白斑恶性肿瘤的敏感性、特异性和准确性分别为 100%、97.4%和 97.8%。kappa 指数为 0.92（95%置信区间 81.1%-100%）。
NBI 内镜作为一种非侵入性检查方法，可准确预测声带白斑的恶性转化风险，因此在临床治疗计划中具有一定的应用价值。
