title: Diagnostic significance of narrow-band imaging for detecting high-grade dysplasia, carcinoma in situ, and carcinoma in oral leukoplakia.
abstract: OBJECTIVE
  To investigate the diagnostic accuracy of the established patterns of intraepithelial microvasculature of narrow-band imaging (NBI) in diagnosing upper aerodigestive tract neoplasm of the squamous epithelium for detecting high-grade dysplasia, carcinoma in situ, and carcinoma in oral leukoplakia.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Using histopathological findings as the standard, clinical diagnosis of oral leukoplakia and 3 different but established NBI criteria were compared and evaluated statistically.
  
  
  RESULTS
  A total of 414 patients, including 365 males and 49 females, with mean age of 52.15 ± 10.75 years, were enrolled. The odds ratio of detecting high-grade dysplasia and carcinomatous lesions by twisted elongation of intraepithelial papillary capillary loop (IPCL) and IPCL pattern destruction was 95.53 (confidence interval 95%: 42.19-216.29), and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.62%, 94.56%, 74.32%, 97.06%, and 93.0%, respectively, which were significantly better than the other two established NBI criteria (p < 0.001).
  
  
  CONCLUSIONS
  The NBI images of twisted elongation of IPCL and IPCL pattern destruction are indicators of high-grade dysplasia or carcinomatous lesions in oral leukoplakia.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan. sweeyang@gmail.com
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Yun-Shien
authors.initials: YS
authors.lastname: Lee
authors.forename: Liang-Che
authors.initials: LC
authors.lastname: Chang
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Hwang
authors.forename: Tai-An
authors.initials: TA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007972:Leukoplakia, Oral / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult