A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
The Feasibility of NBI in Patients With Suspected Upper Airway Lesions: A Multicenter Study
Tekijät: Back LJJ, Rekola J, Raittinen L, Halme E, Pietarinen P, Keski-Santti H, Aaltonen LM, Makitie AA, Raappana A, Tikanto J, Schrey A, Grenman R, Laranne J, Koivunen P, Irjala H
Kustantaja: WILEY
Kustannuspaikka: HOBOKEN
Julkaisuvuosi: 2017
Journal: Laryngoscope
Tietokannassa oleva lehden nimi: LARYNGOSCOPE
Lehden akronyymi: LARYNGOSCOPE
Vuosikerta: 127
Numero: 8
Aloitussivu: 1821
Lopetussivu: 1825
Sivujen määrä: 5
ISSN: 0023-852X
eISSN: 1531-4995
DOI: https://doi.org/10.1002/lary.26526
Tiivistelmä
Objective: Narrow band imaging (NBI) improves diagnosis of laryngopharyngeal cancer, but most reported NBI studies are from experienced centers. Feasibility reports on use at everyday outpatient departments are needed.Study Design: Researcher-initiated, prospective, multicenter.Methods: Participating physicians were instructed in NBI technique during a 4-hour meeting. Patients underwent an examination that included endoscopy with white light (WL) high-definition (HD) TV and NBI filter in the selected time period. All suspicious lesions were biopsied. The medical records of patients with NBI negative findings were evaluated 6 months after the visit to detect all possible malignant lesions coming into view at mucosal sites. These were considered as false-negative cases, enabling long-term assess to the positive predictive value (NPV) of the protocol.Results: We enrolled 125 patients. Of those, 84 (67.2%) were males and the median age was 65 years (range, 35-91). In analysis of the accuracy of WL HD TV and NBI against biopsy, the sensitivity and specificity of WL HD TV were 62% and 81%, respectively; and the sensitivity and specificity of NBI were 100% and 84%, respectively. The diagnostic accuracy of NBI was significantly better (P < 0.05). When analyzing medical records 6 months after the initial examination, we found three patients who had been diagnosed with a malignant lesion (NPV of NBI of 96.8%).Conclusion: Narrow band imaging is readily implemented in an everyday outpatient practice, and there seems to be better detection rates of dysplastic/carcinoma lesions with HD NBI compared to HD WL.
Objective: Narrow band imaging (NBI) improves diagnosis of laryngopharyngeal cancer, but most reported NBI studies are from experienced centers. Feasibility reports on use at everyday outpatient departments are needed.Study Design: Researcher-initiated, prospective, multicenter.Methods: Participating physicians were instructed in NBI technique during a 4-hour meeting. Patients underwent an examination that included endoscopy with white light (WL) high-definition (HD) TV and NBI filter in the selected time period. All suspicious lesions were biopsied. The medical records of patients with NBI negative findings were evaluated 6 months after the visit to detect all possible malignant lesions coming into view at mucosal sites. These were considered as false-negative cases, enabling long-term assess to the positive predictive value (NPV) of the protocol.Results: We enrolled 125 patients. Of those, 84 (67.2%) were males and the median age was 65 years (range, 35-91). In analysis of the accuracy of WL HD TV and NBI against biopsy, the sensitivity and specificity of WL HD TV were 62% and 81%, respectively; and the sensitivity and specificity of NBI were 100% and 84%, respectively. The diagnostic accuracy of NBI was significantly better (P < 0.05). When analyzing medical records 6 months after the initial examination, we found three patients who had been diagnosed with a malignant lesion (NPV of NBI of 96.8%).Conclusion: Narrow band imaging is readily implemented in an everyday outpatient practice, and there seems to be better detection rates of dysplastic/carcinoma lesions with HD NBI compared to HD WL.
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