- 作者：Wen-Hung Wang ; M.D. ; Ph.D.&lowast ; ; Yen-Chun Lin ; M.D.&lowast ; ; sarah_travel@hotmail.com ; Wen-Cheng Chen ; M.D.&dagger ; ; Miao-Fen Chen ; M.D. ; Ph.D.&dagger ; ; Chih-Cheng Chen ; M.D.&Dagger ; ; Kam-Fai Lee ; M.D.§ ;
- 关键词：Endoscopy ; Nasopharyngeal carcinoma (NPC) ; Narrow-band imaging (NBI) ; ROC area ; Sensitivity
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：15 July, 2012
- 卷：83
- 期：4
- 页码：1213-1219
- 文件大小：659 K
Purpose
This study evaluated the feasibility of screening mucosal recurrent nasopharyngeal carcinoma with narrow-band imaging (NBI) endoscopy.Methods and Materials
One hundred and six patients were enrolled. All patients underwent conventional white-light (WL) endoscopic examination of the nasopharynx followed by NBI endoscopy. Biopsies were performed if recurrence was suspected.
Results
We identified 32 suspected lesions by endoscopy in WL and/or NBI mode. Scattered brown spots (BS) were identified in 22 patients, and 4 of the 22 who had negative MRI findings were histopathologically confirmed to be neoplasias that were successfully removed via endoscopy. A comparison of the visualization in NBI closer view corresponded to histopathological findings in 22 BS, and the prevalence rates of neoplasias in tail signs, round signs, and irregularities signs were 0%(0/6), 0%(0/7), and 44.4%(4/9), respectively (p = 0.048). The sensitivity, specificity, and diagnostic capability were 37.5%, 92.9%and 0.652 for WL, 87.5%, 74.5%and 0.810 for NBI, and 87.5%, 87.8%, and 0.876 for NBI closer view, respectively. NBI closer view was effective in increasing specificity compared with NBI alone (87.8%vs. 74.5%, p < 0.05), and in increasing sensitivity and diagnostic capability compared to WL alone (87.5%vs. 37.5%, p < 0.05; 0.876 vs. 0.652, p = 0.0001).
Conclusions
Although NBI in endoscopy can improve sensitivity of mucosal recurrent nasopharyngeal neoplasias, false-positive (nonneoplasia BS) results may be obtained in areas with nonspecific inflammatory changes due to postradiation effects. NBI closer view not only can offer a timely, convenient, and highly reliable assessment of mucosal recurrent nasopharyngeal carcinoma, it can also make endoscopic removal possible.