Wang Dapeng, Li Ning, Guo Ruyuan, Pang Jing, Zhang Li, Zhang Fuli, Zhang Junjie, Yang Xiaotang
Department of Radiation Oncology, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Endoscopy Center, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
J Voice. 2024 Aug 14. doi: 10.1016/j.jvoice.2024.07.002.
To explore the clinical value of narrow band imaging (NBI) endoscopy in the early diagnosis and staging assessment of laryngeal and hypopharyngeal cancer.
A total of 78 patients with lesions in the hypopharynx or larynx were examined using endoscopy, observed under both white light and NBI modes, and graded using NBI. Using Lugol's iodine solution, laryngeal and hypopharyngeal lesions were graded using iodine staining. Using histopathological examination or postoperative pathological results as the diagnostic criteria, the sensitivity, specificity, and accuracy of endoscopy and iodine staining in diagnosing early cancer and precancerous lesions were evaluated.
Multiple lesions were identified by both methods, and pathological examination confirmed 86 lesions, including early squamous cell carcinoma and precancerous lesions, such as early esophageal cancer, high-grade esophageal intraepithelial neoplasia, and hypopharyngeal cancer. Endoscopy showed significantly higher accuracy, detection rate, sensitivity, and specificity in NBI mode than in white light mode (96.12%, 86.05%, 97.37%, 86.67% vs 86.05%, 76.74%, 86.84%, 80%, respectively; P < 0.05). NBI grading and iodine staining grading showed good consistency with pathological diagnosis, with a Kappa value of 0.684 and 0.622, respectively.
NBI endoscopy allows for better observation of subtle structural changes on the surface of lesions compared to white light endoscopy. It provides high accuracy in detecting early laryngeal and hypopharyngeal cancer and precancerous lesions, determining biopsy sites, facilitating early diagnosis, and establishing safe surgical margins. NBI endoscopy offers a viable alternative for non-invasive screening and early diagnosis of laryngeal and hypopharyngeal cancer, showing great potential for clinical advancement.
探讨窄带成像（NBI）内镜在喉癌和下咽癌早期诊断及分期评估中的临床价值。
对78例下咽或喉部病变患者进行内镜检查，在白光和NBI模式下观察，并采用NBI进行分级。使用卢戈氏碘液对喉和下咽病变进行碘染色分级。以组织病理学检查或术后病理结果作为诊断标准，评估内镜检查和碘染色在诊断早期癌症及癌前病变方面的敏感性、特异性和准确性。
两种方法均发现多处病变，病理检查确诊86处病变，包括早期鳞状细胞癌和癌前病变，如早期食管癌、高级别食管上皮内瘤变和下咽癌。内镜检查显示，NBI模式下的准确性、检出率、敏感性和特异性显著高于白光模式（分别为96.12%、86.05%、97.37%、86.67% 对比 86.05%、76.74%、86.84%、80%；P < 0.05）。NBI分级和碘染色分级与病理诊断具有良好的一致性，Kappa值分别为0.684和0.622。
与白光内镜相比，NBI内镜能够更好地观察病变表面的细微结构变化。它在检测早期喉癌和下咽癌及癌前病变、确定活检部位、促进早期诊断以及确定安全手术切缘方面具有较高的准确性。NBI内镜为喉癌和下咽癌的无创筛查和早期诊断提供了一种可行的替代方法，显示出巨大的临床应用潜力。
