Diagnosis Value of Narrow Band Imaging Endoscopy in Evaluating the Degenerative Properties of Vocal Cord Leukoplakia
10.3969/j.issn.1006-7299.2024.06.009
- VernacularTitle:NBI内镜对声带白斑病变性质的评估价值
- Author:
Guangming WANG
1
;
Yan WANG
;
Zhen XU
;
Tao ZHOU
;
Jining QU
;
Qingquan HUA
Author Information
1. 湖北省大冶市人民医院耳鼻咽喉头颈外科(大冶 435100)
- Keywords:
Leukoplakia;
Narrowband imaging;
Endoscopy
- From:
Journal of Audiology and Speech Pathology
2024;32(6):520-523
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis value of narrow band imaging(NBI)endoscopy in evalua-ting the degenerative properties of vocal cord leukoplakia.Methods A retrospective analysis of clinical data from 95 cases(153 sides)of vocal cord leukoplakia patients was conducted.All patients underwent electronic laryngoscopy before microlaryngoscopy.The lesions of vocal cords were examined with white light and then with NBI mode.The superficial IPCL patterns were classified into six types(types Ⅰ-Ⅵ).Under the NBI endoscope,the vocal cord leu-koplakia was classified as 1)Group A:types Ⅰ,Ⅱ,and Ⅲ.The pathological results were regarded as the gold standard for definitive diagnosis of vocal cord leukoplakia.and 2)Group B:types Ⅳ,Ⅴ,and Ⅵ.All patients un-derwent laryngeal microsurgery under general anesthesia,and lesions were sent for pathological examination.The results of NBI assessment were compared with those of pathology.The sensitivity,specificity,accuracy and Kappa-Cohen index of NBI in assessing the nature of lesions were calculated.Results According to NBI endoscopy,123 lesions(80.4％)were classified as low-risk group(type Ⅰ:18,type Ⅱ:41,type Ⅲ:64)and possibly benign le-sions,while 30 lesions(19.6％)were classified as high-risk group(type Ⅳ:2,type Ⅴ:25,type Ⅵ:3)and possi-bly malignant lesions.The pathological results showed that the 121 lesions(79.1％)were hyperkeratosis(20 le-sions),mild(39 lesions),moderate atypical hyperplasia(62 lesions),and the 32 lesions(20.9％)were severe a-typical hyperplasia(5 lesions),carcinoma in situ(22 lesions),and invasive carcinoma(5 lesions).In the low-risk group,2 lateral lesions were pathologically severe atypical hyperplasia.The sensitivity,specificity,positive predic-tive value,negative predictive value,and accuracy of NBI in predicting the malignancy of leukoplacia were 100％,97.6％,90％,100％,and 98％,respectively.Kappa-Cohen index was 0.90(95％confidence interval 82.3％to 100％).Conclusion NBI endoscopy can accurately evaluate the pathological properties of vocal cord leukoplakia.
