The value of narrow band imaging endoscope for early head and neck cancer

OBJECTIVES: To evaluate the diagnostic value of rhinolaryngoscopy using a narrow band imaging (NBI) system in detecting squamous cell carcinoma of the head and neck (SCCHN) in patients with esophageal cancer (EC). STUDY DESIGN: Prospective study. SUBJECTS AND METHODS: Between January 2006 and December 2006, 667 consecutive EC patients underwent rhinolarynooscopy screening with both a white light and an NBI system. Sensitivity, specificity, accuracy, and positive/negative predictive values for detecting SCCHNs were calculated and compared. RESULTS: Forty-five patients (6.7%) of 667 patients had SCCHNs. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for detecting SCCHNs by white fight were 51.1 percent, 99.7 percent, 96.4 percent, 92 percent, and 96.6 percent. In contrast, those by NBI were 97.7 percent**, 98.9 percent. 98.8 percent*, 86.3 percent, and 99.8 percent** (*P < 0.01. **P < 0.001 vs white light). CONCLUSION: An NBI endoscope significantly improves diagnostic accuracy, sensitivity, and negative predictive value in detecting SCCHN in EC patients. This endoscope would be highly beneficial in detecting superficial SCCHNs in high-risk patients. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.