Chidambaram Kalyan, Kumar Parida Pradipta, Mittal Yash, Chappity Preetam, Kumar Samal Dillip, Pradhan Pradeep, Sarkar Saurav, Kumar Adhya Amit
Department of E.N.T., A.I.I.M.S. (All India Institute of Medical Sciences), Bhubaneswar, India.
Department of Otorhinolaryngology and Head & Neck surgery, A.I.I.M.S, Bhubaneswar, 751019 Odisha India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4171-4178. doi: 10.1007/s12070-024-04809-2. Epub 2024 Jun 19.
Head and neck malignancies are associated with poor prognosis and poor quality-of-life if detected late. Narrow-Band-Imaging(NBI) is one of the important tools, which helps in detecting these lesions earlier. By using narrow-wavelength(400-550 nm) it enhances the mucosal and submucosal vascularity against the pale mucosal background which helps us detecting benign, pre-malignant and malignant lesions.
The objective of this study was to evaluate the accuracy of NBI in the diagnosis of various mucosal lesions of head and neck region and its correlation with the histopathology reports.
This was a prospective diagnostic study conducted between June 2020 - June 2022 where 118 patients(oral cavity-28, laryngeal-87,and hypopharyngeal-3) who fulfilled the inclusion and exclusion criteria were recruited. All-118-patients underwent NBI endoscopy under local/general anaesthesia followed by biopsies from the most suspicious-areas. Type of vascular-pattern noted from NBI and their respective histopathological reports were correlated.
The mean age was 53.28 ± 1.24 years ranging from 16 to 88 years. The sensitivity, specificity, Positive-Predictive-Value(PPV) and Negative-Predictive-Value(NPV) in detecting benign lesions were 100%, 90%, 74% and 100% respectively. The sensitivity, specificity, PPV and NPV in detecting premalignant lesions were 70%, 92%, 56% and 96% respectively. The sensitivity, specificity, PPV and NPV in detecting malignant lesions were 83%,97.5%, 98.5% and 97.5% respectively. NBI has a strong association with the histopathological reports, which is statistically significant(p-value < 0.001).
NBI has high classifying various mucosal lesions of head-neck region. Its findings had a strong correlation with histopathological reports.
头颈部恶性肿瘤若发现较晚，预后较差且生活质量不佳。窄带成像（NBI）是重要工具之一，有助于更早地检测出这些病变。通过使用窄波长（400 - 550纳米），它能在苍白的黏膜背景下增强黏膜和黏膜下血管的清晰度，这有助于我们检测良性、癌前和恶性病变。
本研究的目的是评估NBI在诊断头颈部各种黏膜病变中的准确性及其与组织病理学报告的相关性。
这是一项于2020年6月至2022年6月进行的前瞻性诊断研究，招募了118名符合纳入和排除标准的患者（口腔28例、喉部87例、下咽3例）。所有118例患者在局部/全身麻醉下接受NBI内镜检查，随后从最可疑区域进行活检。将NBI观察到的血管模式类型与其各自的组织病理学报告进行关联。
平均年龄为53.28±1.24岁，范围为16至88岁。检测良性病变时的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为100%、90%、74%和100%。检测癌前病变时的敏感性、特异性、PPV和NPV分别为70%、92%、56%和96%。检测恶性病变时的敏感性、特异性、PPV和NPV分别为83%、97.5%、98.5%和97.5%。NBI与组织病理学报告有很强的关联，具有统计学意义（p值<0.001）。
NBI在对头颈部区域各种黏膜病变进行分类方面具有很高的准确性。其结果与组织病理学报告有很强的相关性。
