title: Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial.
abstract: OBJECTIVE
  Most of the esophageal squamous cell carcinomas (ESCCs) and cancers of the head and neck (H&N) region are diagnosed at later stages. To achieve better survival, early detection is necessary. We compared the real-time diagnostic yield of superficial cancer in these regions between conventional white light imaging (WLI) and narrow band imaging (NBI) in high-risk patients.
  
  
  METHODS
  In a multicenter, prospective, randomized controlled trial, 320 patients with ESCC were randomly assigned to primary WLI followed by NBI (n = 162) or primary NBI followed by WLI (n = 158) in a back-to-back fashion. The primary aim was to compare the real-time detection rates of superficial cancer in the H&N region and the esophagus between WLI and NBI. The secondary aim was to evaluate the diagnostic accuracy of these techniques.
  
  
  RESULTS
  NBI detected superficial cancer more frequently than did WLI in both the H&N region and the esophagus (100% v 8%, P < .001; 97% v 55%, P < .001, respectively). The sensitivity of NBI for diagnosis of superficial cancer was 100% and 97.2% in the H&N region and the esophagus, respectively. The accuracy of NBI for diagnosis of superficial cancer was 86.7% and 88.9% in these regions, respectively. The sensitivity and accuracy were significantly higher using NBI than WLI in both regions (P < .001 and P = .02 for the H&N region; P < .001 for both measures for the esophagus, respectively).
  
  
  CONCLUSIONS
  NBI could be the standard examination for the early detection of superficial cancer in the H&N region and the esophagus.
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan. mmuto@kuhp.kyoto-u.ac.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.forename: Keiko
authors.initials: K
authors.lastname: Minashi
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Ichiro
authors.initials: I
authors.lastname: Oda
authors.forename: Satoru
authors.initials: S
authors.lastname: Nonaka
authors.forename: Tai
authors.initials: T
authors.lastname: Omori
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Goda
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kaise
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Shimoda
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
authors.forename: Daizo
authors.initials: D
authors.lastname: Saito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000175:diagnosis; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D055096:Optical Devices; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis; D011230:Precancerous Conditions / Q000175:diagnosis*