Wu J H, Zhou Y, Luo X Y
Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb 7;55(2):104-108. doi: 10.3760/cma.j.issn.1673-0860.2020.02.005.
To investigate the role of narrow band imaging (NBI) endoscopy in diagnosing oral premalignant and malignant lesions. NBI and white light (WLI) endoscopy were performed on 85 patients (47 females, 38 males, aged from 12 to 83 years old, the medium age was 58 years) with 144 oral lesions from July 2016 to October 2017 in the First Affiliated Hospital of Xiamen University. NBI findings were classified into 5 types according to the Ni's classification and compared with histopathological results. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of NBI and WLI were calculated. Accuracy of NBI on premalignant and malignant lesions were compared with that of WLI. The connection between NBI findings and pathological results were investigated. SPSS 22.0 software was used to analyze the data. Sensitivity, specificity, PPV, and NPV of NBI WLI were 96.5% vs 81.2%, 98.3% vs 98.3%, 98.8% vs 98.6%, and 95.1% vs 78.4%, respectively. NBI findings showed high accordance with the phathological results (kappa=0.943,0.01). However, consistency between WLI findings and the phathological results was relatively low (kappa=0.765, 0.01). NBI was more accurate in diagnosing both premalignant (0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, 0.01) than WLI. There was remarkable correlation between NBI findings and the phathological results (0.836, 0.01). NBI shows high accuracy in detecting premalignant and malignant lesions of oral cavity. Ni's NBI classification is helpful to diagnose the premalignant and early malignant lesions as well as to evaluate tumor invasion. Thus, NBI can contribute more to early diagnosis and therapy of premalignant and malignant lesions of oral cavity.
探讨窄带成像（NBI）内镜在口腔癌前病变及恶性病变诊断中的作用。2016年7月至2017年10月，在厦门大学附属第一医院对85例患者（47例女性，38例男性，年龄12至83岁，中位年龄58岁）的144处口腔病变进行了NBI和白光（WLI）内镜检查。根据倪氏分类法将NBI检查结果分为5型，并与组织病理学结果进行比较。计算NBI和WLI的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。比较NBI和WLI对癌前病变和恶性病变的诊断准确性。研究NBI检查结果与病理结果之间的关联。采用SPSS 22.0软件进行数据分析。NBI和WLI的敏感性、特异性、PPV和NPV分别为96.5%对81.2%、98.3%对98.3%、98.8%对98.6%、95.1%对78.4%。NBI检查结果与病理结果高度一致（kappa=0.943，P<0.01）。然而，WLI检查结果与病理结果之间的一致性相对较低（kappa=0.765，P<0.01）。NBI在诊断癌前病变（P<0.01）和恶性病变（尤其是高级别上皮内瘤变，P<0.01）方面比WLI更准确。NBI检查结果与病理结果之间存在显著相关性（r=0.836，P<0.01）。NBI在检测口腔癌前病变和恶性病变方面具有较高的准确性。倪氏NBI分类有助于诊断癌前病变和早期恶性病变以及评估肿瘤浸润情况。因此，NBI可为口腔癌前病变和恶性病变的早期诊断和治疗提供更多帮助。
