Paleri Vinidh, Sawant Rupali, Mehanna Hisham, Ainsworth Holly, Stocken Deborah
The Royal Marsden NHS Foundation Trust, London, UK.
Biostatistics Research Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
Clin Otolaryngol. 2018 Dec;43(6):1439-1442. doi: 10.1111/coa.13182. Epub 2018 Aug 7.
Clinicians have recognised the role of narrow band imaging (NBI) in the management of head and neck cancer in several studies. However, a recent systematic review was unable to pool the data on diagnostic efficacy in this setting owing to the heterogeneity in the published data.
Secondary analysis of data, utilising Bayes' theorem, from meta-analyses and randomised trials.
In patients with a histological diagnosis of mild dysplasia who show no abnormalities on NBI, the post-test probability of malignancy is estimated to be 2.3%, compared to 10.3% with conventional white light imaging (WLI). For severe dysplasia, similar post-test probabilities after NBI and WLI are estimated to be 8.0% and 29.7%, respectively. Post-test probabilities in this setting indicate the chance of missing malignancy following a negative NBI or WLI in patients who undergo no further intervention. This study also provides a nomogram designed for use in this setting.
This study identifies the evidence base for use of NBI in the follow-up for laryngeal dysplasia.
在多项研究中，临床医生已认识到窄带成像（NBI）在头颈部癌症管理中的作用。然而，由于已发表数据的异质性，最近的一项系统评价无法汇总该背景下诊断效能的数据。
利用贝叶斯定理对荟萃分析和随机试验的数据进行二次分析。
组织学诊断为轻度发育异常且NBI检查无异常的患者，恶性肿瘤的检测后概率估计为2.3%，而传统白光成像（WLI）为10.3%。对于重度发育异常，NBI和WLI后的类似检测后概率分别估计为8.0%和29.7%。此背景下的检测后概率表明，在未接受进一步干预的患者中，NBI或WLI结果为阴性时漏诊恶性肿瘤的可能性。本研究还提供了一种适用于此背景的列线图。
本研究确定了在喉发育异常随访中使用NBI的证据基础。
