Prospective study of early detection of pharyngeal superficial carcinoma with the narrowband imaging laryngoscope (original) (raw)
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Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superficial carcinoma
World Journal of Gastroenterology, 2011
Au�hor con�ribu�ions: Yoshimura N, �oda K and Yoshida Y performed the endoscopies and evaluated the endoscopic find� in�s; Kato T and Seino Y ordered narrow�band ima�in� ma�ni� fied endoscopy to inspect oropharyngeal and hypopharyngeal mucosal sites; Tajiri � assisted with the study desi�n; Ike�ami M established the histolo�ical dia�noses; Urashima M was re� sponsible for the statistical analysis of the data; and Yoshimura N and �oda K wrote the paper.
Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging
The Journal of Laryngology & Otology, 2010
Objective:To investigate the characteristics of the laryngeal mucosal microvascular network in suspected laryngeal cancer patients, using narrow band imaging, and to evaluate the value of narrow band imaging endoscopy in the early diagnosis of laryngeal precancerous and cancerous lesions.Patients and methods:Eighty-five consecutive patients with suspected precancerous or cancerous laryngeal lesions were enrolled in the study. Endoscopic narrow band imaging findings were classified into five types (I to V) according to the features of the mucosal intraepithelial papillary capillary loops assessed.Results:A total of 104 lesions (45 malignancies and 59 nonmalignancies) was detected under white light and narrow band imaging modes. The sensitivity and specificity of narrow band imaging in detecting malignant lesions were 88.9 and 93.2 per cent, respectively. The intraepithelial papillary capillary loop classification, as determined by narrow band imaging, was closely associated with the ...
Narrow band imaging as screening test for early detection of laryngeal cancer: a prospective study
Clinical Otolaryngology, 2016
OBJECTIVES: to analyze the specificity and sensibility of Narrow Band Imaging illumination technology in the early detection of laryngeal cancer in the patients' population without previous diagnosis of laryngeal cancer in a screening setting. DESIGN: unicenter, prospective study SETTING: One tertiary medical center PARTECIPANTS: 158 patients completed all protocol steps MAIN OTUCOME MEASURES: sensitivity, specificity, positive and negative predictive values of NBI in detecting precancerous lesions and early laryngeal cancer RESULTS: The blind assessment of NBI patterns concurred in 90% of patients. In identifying laryngeal cancer and its precursor lesions, in-office NBI showed a high sensitivity of 97% (CI, 84.2-99.9%), specificity of 92.5% (CI, 79.6-98.4%), PPV of 91.4%(CI, 76.9-98.2%), NPV of 97.4%(CI,86.2-99.9%) and accuracy of 94.5% but intra-operative NBI demonstrated a sensitivity of 97% (CI,84.2-99.9%), a slightly higher specificity of 95%(CI,83.1-99.4%), PPV of 94.1% (CI,80.3-993%), NPV of 97.4% (CI,86.5-99.9%) and accurancy of 95.9%. The comparative ROC curves
Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites
Cancer, 2004
Head and neck squamous cell carcinoma typically is diagnosed at an advanced stage, and the prognosis for patients with this type of malignancy is poor. Detection of these lesions at an earlier stage (e.g., as carcinoma in situ) would be of clear benefit to patients. However, it has been extremely difficult to detect carcinoma in situ at head and neck mucosal sites during routine endoscopy, even after numerous passes of the endoscope through the oral cavity and the pharynx.
Magnifying endoscope with NBI to predict the depth of invasion in laryngo-pharyngeal cancer
The Laryngoscope, 2014
Objectives/Hypothesis: To examine if macroscopic classification with a magnifying gastrointestinal endoscope with narrow band imaging (ME-NBI) is useful in predicting pathological depth of tumor invasion in laryngo-pharyngeal cancer. Study Design: Retrospective study. Methods: Preoperative endoscopy reports and postoperative pathological reports on 139 laryngo-pharyngeal cancer lesions were retrospectively reviewed, and the association between macroscopic findings in the lesions and the depth of tumor invasion was analyzed statistically. Results: The ratios of lesions macroscopically classified as 0-I (superficial and protruding), 0-IIa (slightly elevated), 0-IIb (true flat), 0-IIc (slightly depressed), and 0-III (superficial and excavated) in the preoperative endoscopy reports were 3%, 25%, 71%, 1%, and 0%, respectively. Regarding the depth of tumor invasion in the postoperative pathological reports, the ratios of lesions classified as EP (carcinoma in situ), SEP (tumor invades subepithelial layer), and MP (tumor invades muscularis propria) were 73%, 26%, and 1%, respectively. The ratios of subepithelial invasion or muscular invasion in 0-I, 0-IIa, and 0-IIb were 100%, 54%, and 14%, respectively, and showed significant difference (P < 0.0001). Only one of 139 lesions invaded the muscular propria. Conclusions: This study is the first one to show that macroscopic findings by ME-NBI predict the depth of tumor invasion in superficial laryngo-pharyngeal cancer. It was indicated that there is a little chance of muscular invasion if the lesion is endoscopically diagnosed as 0-I or 0-II. A new T stage classification based on the depth of tumor invasion may be needed in order to adapt the classification to include transoral surgery.
A new strategy for endoscopic staging of laryngeal carcinoma: multistep endoscopy
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2012
At present, it is difficult to identify a gold standard for endoscopic staging of laryngeal cancer, especially considering the large number of endoscopic instruments available. We have coined the term multistep endoscopy to describe a method for staging laryngeal precancerous and neoplastic lesions that sequentially uses several endoscopic tools including high definition white light endoscopy (HDTV), stroboscopy and autofluorescence endoscopy. During the period from November 2007 to November 2009, 140 patients with a suspect laryngeal lesion underwent multistep endoscopy at the Department of Otorhinolaryngology at Martini Hospital in Turin. All patients were subjected to a series of endoscopic examinations in indirect laryngoscopy (white light endoscopy coupled to a HDTV camera, laryngostroboscopy, indirect autofluorescence) followed by white light endoscopy coupled to a HDTV camera and autofluorescence in direct microlaryngoscopy. The aim of the present prospective study was to eva...
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2008
Head and neck squamous cell carcinoma of the upper aerodigestive tract is well known for its frequently late presentation and diagnosis at an advanced stage. In addition, it is well recognized that it may arise in multiple sites, either synchronously or metachronously. Thus it should be imperative to endoscopically screen the upper aerodigestive tract of patients at risk for head and neck squamous cell carcinoma with a new diagnostic tool, especially due to the fact that early lesions are very difficult to detect even by multiple passes with a standard endoscopy, if they are < or = 1 cm in diameter. Lugol chromoendoscopy, which is mainly used in the oesophagus, is not suitable for the head and neck region due to severe mucosal irritation. Herein, narrow-band imaging is described, a diagnostic tool already proved as a useful screening method in other endoscopic fields, and its application in the early detection of head and neck squamous cell carcinoma is reviewed, as reported by p...
The Journal of Laryngology & Otology, 2013
Objective:To investigate different strategies for displaying the hypopharynx and oesophageal entrance during laryngoscopy for hypopharyngeal cancer.Patients and methods:A total of 113 patients with hypopharyngeal cancer underwent laryngoscopy prior to surgery. The hypopharynx was displayed by: (1) pulling the anterior cervical skin; (2) having the patient perform the Valsalva balloon-blowing manoeuvre; and (3) injecting oxygen through the biopsy channel to expose the oesophageal entrance. The effect of these methods on visualisation of primary tumour size and extent was assessed.Results:During pronunciation of the letter ‘e', the hypopharynx was displayed in only 33 patients (29.2 per cent); with anterior cervical skin traction plus the balloon-blowing manoeuvre, the hypopharynx was displayed in 106 patients (93.8 per cent; p < 0.001). The combined strategy was superior especially when judging the extent of posterior pharyngeal wall and postcricoid invasion. Oesophageal entra...