Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions

Head Neck. 2017 Sep;39(9):1854-1863. doi: 10.1002/hed.24849. Epub 2017 Jun 22.

Abstract

Background: The purpose of this study was to evaluate the value of narrow band imaging (NBI) examination in the office for the diagnosis and follow-up of upper airway premalignant and malignant lesions.

Methods: Four hundred eighty lesions were evaluated with white light endoscopy (WLE) and NBI before a biopsy/excision. Additionally, 151 premalignant lesions were followed up without proven biopsy. Carcinoma-free survival was calculated. The learning curve was analyzed.

Results: Overall, the accuracy improved from 74.1% with WLE to 88.9% with NBI, being relevant in all anatomic subsites. The accuracy of NBI increased significantly with increasing experience (area under the curve [AUC] >0.9). After a follow-up of 25 months, 14 of 151 lesions (9.3%) converted into carcinoma. The 4-year carcinoma-free survival rate was 86.4%. The 4-year carcinoma-free survival rate differed significantly between lesions classified as benign/mild dysplasia versus those presenting as moderate/severe dysplasia (88.9% vs 73.5%; P = .018).

Conclusion: The NBI provided a greater accuracy than WLE and showed promising usefulness for the follow-up of premalignant lesions.

Keywords: chronic laryngitis; dysplasia; endoscopy; head and neck cancer; narrow band imaging; premalignant lesions; squamous cell carcinoma.

MeSH terms

  • Aged
  • Area Under Curve
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Likelihood Functions
  • Male
  • Middle Aged
  • Narrow Band Imaging / methods*
  • Office Visits
  • Precancerous Conditions / diagnostic imaging
  • Precancerous Conditions / pathology*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Squamous Cell Carcinoma of Head and Neck