Narrowband imaging for early detection of malignant tumors and radiation effect after treatment of head and neck cancer.
OBJECTIVE
To determine the value of narrowband imaging (NBI) screening for the early detection of head and neck squamous cell carcinoma (HNSCC) in patients who have received treatment and to assess the impact of radiotherapy on detection rates.


METHODS
Cross-sectional study.


METHODS
Tertiary referral center.


METHODS
From July 1, 2007, through February 28, 2008, a total of 206 patients with HNSCC underwent rhinolarynx videoendoscopic screening performed using conventional white-light and NBI systems during their routine postoperative sessions.


METHODS
The rate of detecting malignant tumors, depending on the anatomical site and stage of cancer and the history of radiotherapy after primary treatment.


RESULTS
We identified 68 lesions by endoscopy in conventional white-light and/or NBI mode. Of these, 62 were histopathologically confirmed to be cancerous. The rates of detecting cancerous lesions by white-light and NBI modes were 100% and 97% for oral lesions, 69% and 100% for oropharyngeal lesions (P = .02), and 39% and 100% for hypopharyngeal lesions (P = .001), respectively. No difference was found between the 2 modes with regard to the detection of visible T1 to T4 tumors. However, NBI mode was significantly better than white-light mode for the detection of carcinoma in situ (P < .001).


CONCLUSIONS
We found that NBI-assisted endoscopy is highly useful for the detection of precancerous lesions in the oropharyngeal and hypopharyngeal mucosa and is not affected by a history of radiotherapy in patients with HNSCC.
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University at Chiayi, Taiwan.
Yen-Chun
YC
Lin
Akihito
A
Watanabe
Wen-Cheng
WC
Chen
Kam-Fai
KF
Lee
I-Lin
IL
Lee
Wen-Hung
WH
Wang
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000532:radiotherapy; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis; D014741:Video Recording