Diagnostic value of image enhancement endoscopy in sinonasal malignancy
10.3760/cma.j.cn115330-20240612-00346
- VernacularTitle:图像增强内镜系统对鼻腔鼻窦恶性肿瘤的诊断价值
- Author:
Min LI
1
;
Cheng LI
;
Yan SUN
;
Zhenxiao HUANG
;
Jing QU
;
Shunjiu CUI
;
Qian HUANG
;
Bing ZHOU
Author Information
1. 康复大学青岛医院（青岛市市立医院）甲状腺疾病诊疗科，青岛 266000
- Publication Type:Journal Article
- Keywords:
Endoscopes;
Nose neoplasms;
Paranasal sinus neoplasms;
Diagnosis;
Image enhancement endoscopy;
Ni′ endoscopic classification
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(4):420-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic value of image enhancement endoscopy (IEE) for sinonasal malignant tumors.Methods:Patients with nasal neoplasms at the Department of Otorhinolaryngology Head and Neck Surgery at Beijing Tongren Hospital from January 2019 to December 2021 were examined using white light endoscopy (WLE) and IEE. Targeted biopsy was performed after image collection, and the images were analyzed by two blinded observers. Pathological diagnosis was compared with endoscopic findings. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and P<0.05 was statistically significant. Kappa(k) was employed to assess consistency between endoscopic and histopathological diagnoses. The vascular patterns of sinonasal malignancy were compared with Ni endoscopic classification.Results:This study ultimately included 193 patients with nasal tumors, and 41 cases (21.24%, 41/193) were comfirmed histopathologically with sinonasal malignancies. WLE correctly diagnosed 18 cases (43.90%, 18/41), while IEE diagnosed 28 cases (68.29%, 28/41). Among the 41 malignancies, 28 cases (68.29%, 28/41) showed patchy/punctate patterns and tortuous vessels (Ni type Ⅴ). All 14 squamous epithelium-derived malignancies (34.15%, 14/41) had Ni type Ⅴ vessels. Of 27 non-squamous malignancies, 14 cases (34.15%, 14/41) were Ni type Ⅴ, 7 cases (17.07%, 7/41) were false negatives, 6 cases (14.63%, 6/41) that their vessels were obscured by necrotic tissue. Compared to WLE, IEE had higher sensitivity (80.00% vs 51.42%), specificity (98.68% vs 96.69%), PPV (93.33% vs 78.26%), NPV (95.51% vs 89.57%), diagnostic consistency (95.16% vs 88.17%), and κ value (0.832 vs 0.554). Conclusions:IEE improves the endoscopic diagnosis of sinonasal malignancies. Ni type Ⅴ is suitable for the diagnosis of malignant tumors of squamous epithelial malignant tumors.
