Arthur Clement, Huangfu Hui, Li MengLu, Dong Zhen, Asamoah Emmanuel, Shaibu Zakari, Zhang Di, Ja Lina, Obwoya Rubangakene T, Zhang Chunming, Han Rui, Yan Xiuwen, Zhang Sen, Dakura Christina, Dormocara Amos, Yu Wenjie
Department of Otolaryngology-Head & Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China; Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China; Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Otolaryngology-Head & Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China; Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China; Shanxi Province Clinical Medical Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
J Voice. 2023 Oct 25. doi: 10.1016/j.jvoice.2023.09.008.
By displaying tumor-specific neoangiogenesis, narrow band imaging (NBI), a novel imaging approach, enhances the diagnosis of head and neck cancers and makes it more accurate OBJECTIVE: To determine the effect of NBI in combination with white light endoscopy (WLE) for diagnosis of preneoplastic or neoplastic laryngeal cancers according to Ni classification and to conclude if higher Ni classification and tumor stage are related.
We enrolled 114 patients with various laryngeal cancer between December 2018 and June 2021. Patients were examined with WLE and NBI. Squamous cell carcinoma (SCC) accounted for 46 cases, benign lesions 30 cases, and nondysplastic, low-grade, and severe dysplasias for 38 cases. Based on characteristics of the intraepithelial papillary capillary loop (IPCL), endoscopic NBI results were divided into five categories (I, II, III, IV, and V). Type I-IV are regarded to be benign, while type V is considered to be cancerous. An incisional biopsy was conducted to assess histopathology, and the histopathology was compared to the NBI results. We assessed the negative predictive value (NPV), positive predictive value (PPV), specificity, and sensitivity for WLE alone and WLE combined with NBI. Analyses were conducted using SPSS software version 26.
The WLE combined with NBI showed excellent sensitivity (96%) compared to WLE (86.4%). Specificity was higher in the WLE combined with NBI (96.4%) than WLE alone (91.7%). WLE combined with NBI saw a NPV of 89% as compared with WLE with 88%. WLE and WLE in combination with NBI, recorded a PPV of 90% and 98%, respectively.
The accuracy of detecting laryngeal cancer increases when WLE and NBI are combined. Combined NBI with WLE remains highly sensitive to early glottis cancer. Accuracy of preoperative NBI was high. In the diagnosis of laryngeal cancer, a higher Ni classification closely correlates with the late stages of the glottis tumor.
窄带成像（NBI）作为一种新型成像方法，通过显示肿瘤特异性新生血管生成，增强了头颈癌的诊断并使其更加准确。目的：根据Ni分类确定NBI联合白光内镜检查（WLE）对癌前或肿瘤性喉癌的诊断效果，并得出Ni分类和肿瘤分期较高是否相关的结论。
我们纳入了2018年12月至2021年6月期间的114例患有各种喉癌的患者。对患者进行了WLE和NBI检查。其中鳞状细胞癌（SCC）46例，良性病变30例，非发育异常、低度发育异常和重度发育异常38例。根据上皮内乳头毛细血管袢（IPCL）的特征，内镜NBI结果分为五类（I、II、III、IV和V）。I-IV型被认为是良性的，而V型被认为是癌性的。进行了切开活检以评估组织病理学，并将组织病理学与NBI结果进行比较。我们评估了单独WLE以及WLE联合NBI的阴性预测值（NPV）、阳性预测值（PPV）、特异性和敏感性。使用SPSS 26版软件进行分析。
与WLE（86.4%）相比，WLE联合NBI显示出优异的敏感性（96%）。WLE联合NBI的特异性（96.4%）高于单独的WLE（91.7%）。WLE联合NBI的NPV为89%，而WLE为88%。WLE以及WLE联合NBI的PPV分别为90%和98%。
WLE和NBI联合使用时，检测喉癌的准确性会提高。NBI与WLE联合对早期声门癌仍高度敏感。术前NBI的准确性较高。在喉癌诊断中，较高的Ni分类与声门肿瘤的晚期密切相关。
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