Sahu Pankaj Kumar, Paramasivam Praveen Kumar, Dutta Angshuman, Gupta Devendra Kumar, Marlapudi Sudheer Kumar
MS (HR), West Block - VI, Air Headquarters, R K Puram, New Delhi, India.
Senior Resident (ENT/HNS), Command Hospital (Eastern Command), Kolkata, India.
Med J Armed Forces India. 2024 Sep-Oct;80(5):566-571. doi: 10.1016/j.mjafi.2024.04.018. Epub 2024 Jul 4.
Narrow band imaging (NBI) is an emerging modality that enhances the accuracy of detection of head and neck malignancies by visualisation of aberrant neoangiogenesis in malignant tissue using narrow bandwidth light in blue and green spectrum. The purpose of this study was to assess the role of NBI in detecting recurrence in patients with Squamous cell carcinoma larynx and hypopharynx who have undergone Radiotherapy/Chemoradiotherapy (RT/CTRT). The aim of the study was to (a) determine the role of NBI in follow-up of patients with carcinoma of larynx and hypopharynx previously treated with radiotherapy or chemotherapy, (b) determine the role of NBI as the initial investigatory tool of choice in detecting local recurrence and compare with other modalities like fibreoptic laryngoscopy (FOL), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography- Computed Tomography (PETCT).
Prospective multicentric study at ENT departments of tertiary care centres in Delhi, Bangalore and Pune in India was conducted from Jan 2019 to Sep 2022. Thirty-four consecutive patients diagnosed as squamous cell carcinoma (SCC) larynx/hypopharynx who underwent chemo/radiotherapy were scheduled for NBI 12 weeks after completion of therapy with FOL and PETCT/MRI and followed up 03 monthly for 02 years. NBI/FOL/PETCT or MRI and Histopathological Examination (HPE) were compared.
NBI was found to be 100% sensitive and 96% specific with a positive predictive value of 85% and negative predictive value of 100% respectively with a diagnostic accuracy of 97%.
NBI along with FOL increases the sensitivity of detection of recurrence in patients of laryngeal/hypopharyngeal cancer post-chemo/radiotherapy.
窄带成像（NBI）是一种新兴的检查方式，它通过利用蓝色和绿色光谱中的窄带宽光可视化恶性组织中异常的新生血管生成，从而提高头颈部恶性肿瘤检测的准确性。本研究的目的是评估NBI在接受放疗/放化疗（RT/CTRT）的喉和下咽鳞状细胞癌患者中检测复发的作用。该研究的目的是：（a）确定NBI在先前接受过放疗或化疗的喉和下咽癌患者随访中的作用；（b）确定NBI作为检测局部复发的首选初始检查工具的作用，并与其他检查方式如纤维喉镜检查（FOL）、磁共振成像（MRI）和正电子发射断层扫描-计算机断层扫描（PETCT）进行比较。
2019年1月至2022年9月在印度德里、班加罗尔和浦那的三级医疗中心耳鼻喉科进行了一项前瞻性多中心研究。34例连续诊断为喉/下咽鳞状细胞癌（SCC）并接受了化疗/放疗的患者在治疗完成12周后安排进行NBI检查，并同时进行FOL以及PETCT/MRI检查，随后每3个月随访1次，共随访2年。对NBI/FOL/PETCT或MRI与组织病理学检查（HPE）进行比较。
发现NBI的敏感性为100%，特异性为96%，阳性预测值为85%，阴性预测值为100%，诊断准确性为97%。
NBI与FOL一起提高了化疗/放疗后喉/下咽癌患者复发检测的敏感性。
