Department of Otolaryngology-Head and Neck Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6 of Taoyuan Street, Nanning, 530021, Qingxiu District, China.
World J Surg Oncol. 2018 Jul 4;16(1):126. doi: 10.1186/s12957-018-1423-5.
This study aims to explore the feasibility of narrow-band imaging (NBI) applied for the diagnostic screening of a high-risk population of nasopharyngeal carcinoma (NPC) and increase the accuracy rate of nasopharyngeal biopsy and the diagnosis rate of early-stage patients.
The positive high-risk population of NPC to EB virus antibody was followed up. At the same time, serological screening and pharyngorhinoscopy were carried out. The specific methods were as follows: (1) all subjects received nasopharyngeal examinations through both the HD endoscopic white light mode (WL) and NBI mode, (2) nasopharyngeal biopsy was conducted on positive subjects with microscopic examination, and, finally, (3) a comparative analysis was conducted between the biopsy pathology results and microscopy results. In addition, the following comparative indicators were recorded under different modes: sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio. Then, the area under the ROC curve and the kappa coefficient were calculated.
A total of 115 subjects were detected to be positive by microscopic examination under the WL mode. Among these subjects, 19 subjects were diagnosed with NPC. In addition, 24 subjects were detected to be positive by microscopic examination under the NBI mode. Among these subjects, 23 subjects were diagnosed with NPC. Under the WL mode, the specific values of the comparative indicators were as follows: sensitivity, 82.61%; specificity, 0%; and area under the ROC curve, 0.413. Furthermore, the WL mode in the diagnosis on the high-risk population of NPC exhibited poor consistency with the biopsy pathology results (kappa coefficient = - 0.069). Under the NBI mode, the specific values of the comparative indicators were as follows: sensitivity, 100%; specificity, 98.96%; and area under the ROC curve, 0.995. Furthermore, the NBI mode in the diagnosis on the high-risk population of NPC exhibited relatively satisfactory consistency with the biopsy pathology results (kappa coefficient = 0.973). Therefore, the NBI mode is significantly superior to the WL mode.
NBI endoscopic examinations should be conducted on a routine basis for high-risk populations of NPC. This can decrease the frequency of biopsies and enhance diagnostic effects.
本研究旨在探讨窄带成像（NBI）应用于鼻咽癌（NPC）高危人群诊断筛查的可行性，提高鼻咽活检的准确率和早期患者的诊断率。
对 EBV 抗体阳性的 NPC 高危人群进行随访，同时进行血清学筛查和鼻咽镜检查，具体方法如下：（1）所有受试者均采用高清内镜白光模式（WL）和 NBI 模式进行鼻咽检查，（2）对阳性者行鼻咽活检，行显微镜检查，（3）对活检病理结果与显微镜结果进行对比分析。此外，记录不同模式下的以下对比指标：灵敏度、特异度、准确率、阳性似然比、阴性似然比。然后计算 ROC 曲线下面积和 Kappa 系数。
在 WL 模式下，显微镜检查共检测到 115 例阳性者，其中 19 例诊断为 NPC。此外，在 NBI 模式下，显微镜检查共检测到 24 例阳性者，其中 23 例诊断为 NPC。在 WL 模式下，对比指标的具体值如下：灵敏度 82.61%；特异度 0%；ROC 曲线下面积 0.413。此外，WL 模式对 NPC 高危人群的诊断与活检病理结果一致性较差（Kappa 系数=-0.069）。在 NBI 模式下，对比指标的具体值如下：灵敏度 100%；特异度 98.96%；ROC 曲线下面积 0.995。此外，NBI 模式对 NPC 高危人群的诊断与活检病理结果一致性较好（Kappa 系数=0.973）。因此，NBI 模式明显优于 WL 模式。
对 NPC 高危人群应常规进行 NBI 内镜检查，减少活检次数，提高诊断效果。
