Value of Narrow Band Imaging (NBI) in Management of Leukoplakia
Authors:
L. Staníková 1; H. Kučová 1; R. Walderová 1; Karol Zeleník 1,2; Pavel Komínek 1,2
Authors‘ workplace:
Klinika otorinolaryngologie a chirurgie hlavy a krku, Fakultní nemocnice Ostrava
1; Ostravská univerzita, Lékařská fakulta, Katedra kraniofaciálních oborů, Ostrava
2
Published in:
Otorinolaryngol Foniatr, 64, 2015, No. 4, pp. 186-190.
Category:
Original Article
Overview
Aim:
To investigate the impact of Narrow Band Imaging (NBI) in prehistological in vivo diagnostic of laryngeal leukoplakia.
Materials and methods:
One hundred twenty-six patients were investigated using white light HD laryngoscopy and Narrow Band Imaging in 6/2013-6/2015. Indication criteria included: chronic laryngitis, hoarseness more than 3 weeks or macroscopic laryngeal lesion. Twenty-six patients with a flat laryngeal leukoplakia were enrolled to the study. Patients were divided to 2 groups – group I (malign intraepithelial papillary capillary loop (IPCL) changes, viewed using NBI endoscopy around the leukoplakia) and group II (leukoplakia with surrounding benign vascular network by NBI endoscopy). Pathological IPCL (group I) were evaluated by histological examination, results were compared with pre histological NBI diagnosis. Benign vascular network surrounding of leukoplakia was checked by NBI endoscopy after 2-3 months, extension of leukoplakia and capillary changes were evaluated. In cases of leukoplakia growth progression or new pathologic IPCL changes histological examination was indicated in these lesions.
Results:
7/26 (26.9%) patients were enrolled to group I, 19/26 (73.1%) to the group II. In group I all 7/7 patients were histologically investigated – carcinoma in situ or invasive squamous cell carcinoma were confirmed in 5/7 cases (71.4%). In group II progression of leukoplakia growth were reported by check NBI endoscopy in 11/19 (57.9%) cases, in those cases histologically hyperkeratosis or low-grade dysplasia were approved, squamous cell carcinoma was not confirmed in any case. In other patients in group II (8/19, 42.1%) the same extension of lesion or regression of leukoplakia were detected by NBI endoscopy.
Conclusion:
Macroscopic appearance of leukoplakia could be variable in white light, so using Narrow Band Imaging is convenient to improve the evaluation of flat laryngeal leukoplakias based on optic pre histological diagnostics. Narrow correlation between NBI features and results of histological examination leads to the conclusion, that lesion with negative NBI endoscopy may be indicated to long-term endoscopy follow-up without histological evaluation.
Keywords:
leukoplakia, squamous cell carcinoma of larynx, narrow band imaging, endoscopy
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
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