Narrow band imaging as screening test for early detection of laryngeal cancer: a prospective study

Abstract

 Objectives

to analyze the specificity and sensibility of Narrow Band Imaging illumination technology in the early detection of laryngeal cancer in the patients' population without previous diagnosis of laryngeal cancer in a screening setting.

Design

unicenter, prospective study.

Setting

One tertiary medical center.

Partecipants

158 patients completed all protocol steps.

Main otucome measures

sensitivity, specificity, positive and negative predictive values of NBI in detecting precancerous lesions and early laryngeal cancer.

Results

The blind assessment of NBI patterns concurred in 90% of patients. In identifying laryngeal cancer and its precursor lesions, in-office NBI showed a high sensitivity of 97% (CI, 84.2-99.9%), specificity of 92.5% (CI, 79.6-98.4%), PPV of 91.4%(CI, 76.9-98.2%), NPV of 97.4%(CI,86.2-99.9%) and accuracy of 94.5% but intra-operative NBI demonstrated a sensitivity of 97% (CI,84.2-99.9%), a slightly higher specificity of 95%(CI,83.1-99.4%), PPV of 94.1% (CI,80.3-993%), NPV of 97.4% (CI,86.5-99.9%) and accurancy of 95.9%. The comparative ROC curves confirmed a slightly higher performance for the intra-operative NBI evaluation without any statistical significance (p=0.41).

Conclusions

Our results confirm the high values of sensitivity and specificity of NBI system in detecting pre-neoplastic laryngeal lesions or early laryngeal cancer in a patients' population selected only by means of risk factors exposure and confirmed the potential role of NBI evaluation as in-office screening tool.

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