title: Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: validation of a new endoscopic clinical classification.
abstract: BACKGROUND
  The purpose of this study was to assess the value of narrow band imaging (NBI) endoscopy in the diagnosis of pharyngolaryngeal lesions and to demonstrate the validity of a new NBI-based classification of their vascular pattern.
  
  
  METHODS
  From 2009 to 2011, 248 patients with pharyngolaryngeal lesions underwent NBI-endoscopic evaluation. NBI findings were classified into 5 types according to the Ni classification and were compared with histopathological reports. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) were calculated.
  
  
  RESULTS
  Sensitivity, specificity, accuracy, PPV, and NPV were 97.4%, 84.6%, 92.7%, 91.6%, and 95.1%, respectively. Ninety-eight percent of histologically malignant lesions corresponded to type V endoscopic pattern, whereas 84.8% of the non-neoplastic lesions corresponded to a type I to IV pattern.
  
  
  CONCLUSIONS
  The NBI ability to detect changes in the mucosal microvasculature can be useful for distinguishing nonmalignant from malignant lesions. An internationally accepted NBI-endoscopic classification may contribute to the further definition of the diagnostic validity of this technique.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bertino
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cacciola
authors.forename: Wladir Bastos
authors.initials: WB
authors.lastname: Fernandes
authors.forename: Carolina Muniz
authors.initials: CM
authors.lastname: Fernandes
authors.forename: Antonio
authors.initials: A
authors.lastname: Occhini
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Marco
authors.initials: M
authors.lastname: Benazzo
mesh_terms: D002277:Carcinoma / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D007830:Larynx / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D011230:Precancerous Conditions / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: dysplasia; endoscopy; head and neck cancer; laryngeal neoplasm; narrow band imaging