Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superfi cial carcinoma  

作　　者：Noboru Yoshimura Kenichi Goda Hisao Tajiri Yukinaga Yoshida Takakuni Kato Yoichi Seino Masahiro Ikegami Mitsuyoshi Urashima 

机构地区：[1]Department of Endoscopy, The Jikei University School of Medicine [2]Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine [3]Department of Otorhinolaryngology, The Jikei University School of Medicine [4]Department of Pathology, The Jikei University School of Medicine [5]Clinical Research and Development, The Jikei University School of Medicine

出　　处：《World Journal of Gastroenterology》2011年第45期4999-5006,共8页世界胃肠病学杂志（英文版）

基　　金：Supported by A Grant-in-Aid for Cancer Research (18-8) from the Ministry of Health, Labour and Welfare of Japan

摘　　要：AIM: To investigate the endoscopic features of pharyngeal superfi cial carcinoma and evaluate the utility of narrow-band imaging (NBI) for this disease. METHODS: In the present prospective study, 335 patients underwent conventional white light (CWL) en-doscopy and non-magnifi ed/magnifi ed NBI endoscopy, followed by an endoscopic biopsy, for 445 superfi cial lesions in the oropharynx and hypopharynx. The macroscopic appearance of superfi cial lesions was categorized as either elevated (< 5 mm in height), flat, or depressed (not ulcerous). Superficial carcinoma (SC) was defi ned as a superfi cial lesion showing high-grade dysplasia or squamous cell carcinoma on histology. The color, delineation, and macroscopic appearances of the lesions were evaluated by CWL endoscopy. The ratio of the brownish area/intervascular brownish epithelium (IBE), as well as microvascular proliferation, dilation, and irregularities, was determined by non-magnifi ed/ magnifi ed NBI endoscopy. An experienced pathologist who was unaware of the endoscopic fi ndings made the histological diagnoses. By comparing endoscopic fi ndings with histology, we determined the endoscopic features of SC and evaluated the diagnostic utility of NBI. RESULTS: The 445 lesions were divided histologically into two groups: a non-SC group, including non-neoplasia and low-grade dysplasia cases, and an SC group. Of the 445 lesions examined, 333 were classified as non-SC and 112 were classif ied as SC. There were no significant differences in age, gender, or the location of the lesions between the patients in the two groups. The mean diameter of the SC lesions was signif icantly greater than that of non-SC lesions (11.0 ± 7.6 mm vs 4.6 ± 3.6 mm, respectively, P < 0.001). Comparisons of CWL endoscopy fi ndings for SC and non-SC lesions by univariate analysis revealed that the incidence of redness (72% vs 41%, respectively, P < 0.001) and a flat or depressed type of lesion (58% vs 44%, respectively, P = 0.013) was significantly higher in the SC group. Using non-magnAIM： To investigate the endoscopic features of pharyngeal superfi cial carcinoma and evaluate the utility of narrow-band imaging （NBI） for this disease. METHODS： In the present prospective study, 335 patients underwent conventional white light （CWL） en-doscopy and non-magnifi ed/magnifi ed NBI endoscopy, followed by an endoscopic biopsy, for 445 superfi cial lesions in the oropharynx and hypopharynx. The macroscopic appearance of superfi cial lesions was categorized as either elevated （ 5 mm in height）, flat, or depressed （not ulcerous）. Superficial carcinoma （SC） was defi ned as a superfi cial lesion showing high-grade dysplasia or squamous cell carcinoma on histology. The color, delineation, and macroscopic appearances of the lesions were evaluated by CWL endoscopy. The ratio of the brownish area/intervascular brownish epithelium （IBE）, as well as microvascular proliferation, dilation, and irregularities, was determined by non-magnifi ed/ magnifi ed NBI endoscopy. An experienced pathologist who was unaware of the endoscopic fi ndings made the histological diagnoses. By comparing endoscopic fi ndings with histology, we determined the endoscopic features of SC and evaluated the diagnostic utility of NBI. RESULTS： The 445 lesions were divided histologically into two groups： a non-SC group, including non-neoplasia and low-grade dysplasia cases, and an SC group. Of the 445 lesions examined, 333 were classified as non-SC and 112 were classif ied as SC. There were no significant differences in age, gender, or the location of the lesions between the patients in the two groups. The mean diameter of the SC lesions was signif icantly greater than that of non-SC lesions （11.0 ± 7.6 mm vs 4.6 ± 3.6 mm, respectively, P 0.001）. Comparisons of CWL endoscopy fi ndings for SC and non-SC lesions by univariate analysis revealed that the incidence of redness （72% vs 41%, respectively, P 0.001） and a flat or depressed type of lesion （58% vs 44%, respectively, P = 0.013） was significantly

关 键 词：Narrow-band imaging Magnified endoscopy Endoscopic diagnosis PHARYNX Pharyngeal cancer Superfi cial carcinoma Squamous cell carcinoma DYSPLASIA 

分 类 号：R739.63[医药卫生—肿瘤]