Narrow band imaging for risk stratification of glottic cancer within leukoplakia

Background This study investigates relevance of narrow band imaging (NBI) in stratifying risk of malignant transformation within leukoplakia. Methods We conducted a prospective analysis that included 62 patients with 91 changes of leukoplakia on vocal folds. The NBI was obtained before microsurgery....

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Bibliographic Details
Published in:Head & neck 2018-10, Vol.40 (10), p.2149-2154
Main Authors: Rzepakowska, Anna, Sielska‐Badurek, Ewelina, Żurek, Michal, Osuch‐Wójcikiewicz, Ewa, Niemczyk, Kazimierz
Format: Article
Language:English
Subjects:
Benign
Diagnosis
Dysplasia
Endoscopy
Epithelium
glottic cancer
Head and neck
Invasiveness
Leukokeratosis
leukoplakia
Malignancy
Microsurgery
narrow band imaging
precancerous conditions
vocal fold
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Summary:Background This study investigates relevance of narrow band imaging (NBI) in stratifying risk of malignant transformation within leukoplakia. Methods We conducted a prospective analysis that included 62 patients with 91 changes of leukoplakia on vocal folds. The NBI was obtained before microsurgery. Categorization of the lesion as benign was made when vessels of surrounding epithelium were classified as type I, II, or IV according to Ni classification. If there were visualized intraepithelial papillary capillary loops of type V, the lesion was classified as malignant. Results were compared to the histopathological diagnosis. Results The NBI assessment classified 75 lesions (82.4%) as benign and 16 (17.6%) as malignant. Histopathological results revealed the diagnosis of no dysplastic changes or low grade dysplasia in 77 cases (84.6%). Another 14 cases (15.4%) occurred with high‐grade dysplasia, carcinoma in situ, and invasive cancer. Sensitivity, specificity, and accuracy of NBI in predicting malignancy within leukoplakia were 100%, 97.4%, and 97.8%, respectively. The kappa index was 0.92 (95% confidence interval 81.1%‐100%). Conclusion The noninvasive procedure of an NBI endoscopy may be recommended as an accurate method in predicting the risk of malignant transformation within the vocal fold leukoplakia and, therefore, would be useful in the clinic for planning the patient's therapy.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.25201