University Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia.
Faculty of Medicine, Korytkova 2, 1000, Ljubljana, Slovenia.
Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1715-1723. doi: 10.1007/s00405-020-05864-5. Epub 2020 Feb 28.
According to the classification of glottic lesions by narrow-band imaging (NBI) proposed by the European Laryngological Society (ELS), lesions without perpendicular patterns are benign, while wide- and narrow-angled perpendicular lesions include both papilloma and carcinoma/high-grade lesions, respectively. The purpose of the study was to investigate the effectiveness of the ELS classification.
One hundred and forty four patients with glottic lesions underwent microlaryngoscopy with NBI. The affected vocal cords (arm A) were histologically analysed. The unaffected vocal cords (arm B) were not histologically analysed and were considered to be true negatives if no suspicious changes appeared during the follow-up. The vocal cords from arm A were categorised into three groups-those with a benign disease (papilloma excluded), those with a carcinoma/high-grade lesion and those with papilloma. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test.
Perpendicular patterns were identified only in 9.3% (9/97) of those in the benign group (without papilloma). Wide-angled patterns were mainly identified in cases of papilloma (80%, 12/15), while the narrow-angled ones were mostly identified in cases of carcinoma and high-grade lesions (96.2%, 76/79) (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 98%, 95%, 88%, 99% and 95%, respectively.
The ELS classification of vocal cord lesions by NBI is effective in differentiating between carcinoma/high-grade lesions and papilloma and the remaining benign lesions of the vocal cords.
根据欧洲喉科学会（ELS）提出的窄带成像（NBI）声带病变分类，无垂直模式的病变为良性，而宽角和窄角垂直病变分别包括乳头状瘤和癌/高级别病变。本研究旨在探讨 ELS 分类的有效性。
144 例声带病变患者行 NBI 显微镜检查。受影响的声带（A 臂）进行组织学分析。未受影响的声带（B 臂）未进行组织学分析，如果在随访过程中未出现可疑变化，则被视为真正的阴性。将 A 臂的声带分为三组：良性疾病（排除乳头状瘤）、癌/高级别病变和乳头状瘤。确定血管模式的比例，并使用卡方检验对各组进行统计学比较。
仅在良性组（无乳头状瘤）中，垂直模式仅占 9.3%（9/97）。宽角模式主要见于乳头状瘤（80%，12/15），而窄角模式主要见于癌和高级别病变（96.2%，76/79）（P<0.001）。灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为 98%、95%、88%、99%和 95%。
NBI 对声带病变的 ELS 分类在区分癌/高级别病变和乳头状瘤以及声带的其他良性病变方面是有效的。
