Narrow-band imaging provides reliable screening for esophageal malignancy in patients with head and neck cancers.
OBJECTIVE
The narrow-band imaging (NBI) system is a novel technology that enhances the visualization of microvasculature and mucosal patterns. The aim of this study was to assess the reliability of the NBI system for esophageal cancer screening in patients with head and neck cancers.


METHODS
A total of 142 patients with head and neck squamous cell carcinoma (SCC) were examined by NBI endoscopy, followed by Lugol chromoendoscopy between April 2006 and June 2008 at the Okayama University Hospital, Okayama, Japan. Detection of SCC and high-grade intraepithelial neoplasia (HGIN) was conducted.


RESULTS
The median age of the patients was 64 years (range: 29-86 years), and approximately three-fourths of all the patients were male. In total, 21 superficial lesions in 16 patients were detected by NBI endoscopy. Of these, 4 lesions were diagnosed histologically as SCC and 11 lesions as HGIN. An additional 22 Lugol-voiding lesions >or=5 mm were detected in 19 patients by Lugol chromoendoscopy. Although 1 of these lesions was diagnosed as HGIN, 21 lesions were diagnosed as low-grade intraepithelial neoplasia or lesions without atypical findings. The sensitivity of NBI endoscopy for detecting esophageal SCC and HGIN was 90.9% (95% confidence interval (CI), 58.7-99.8), specificity was 95.4% (95% CI, 90.3-98.3), and accuracy was 95.1% (95% CI, 90.1-98.0).


CONCLUSIONS
NBI seems to be useful and reliable for screening for esophageal SCC in patients with head and neck cancers.
Takenaka
Ryuta
R
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. ryuta-t@mx31.tiki.ne.jp
Kawahara
Yoshiro
Y
Okada
Hiroyuki
H
Hori
Keisuke
K
Inoue
Masafumi
M
Kawano
Seiji
S
Tanioka
Daisuke
D
Tsuzuki
Takao
T
Uemura
Masayuki
M
Ohara
Nobuya
N
Tominaga
Susumu
S
Onoda
Tomoo
T
Yamamoto
Kazuhide
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000556:secondary*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation; D007454:Iodides; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods
D004396:Coloring Agents; D007454:Iodides; C010389:Lugol's solution