title: The diagnostic value of narrow band imaging in different oral and oropharyngeal subsites.
abstract: The diagnostic value of narrow band imaging (NBI) in the "optical biopsy" of leukoplakias (LP) and erythroplakias (EP) in different oral cavity (OC) and oropharyngeal (OP) subsites is still to be defined. We evaluated 128 unbiopsied and untreated OC/OP LP and EP by conventional oral examination (COE), white light (WL) endoscopy, and NBI and categorized them as "suspicious" or "innocuous". All lesions were treated by excisional biopsy. True positives were those considered as "suspicious" and with histopathology ranging from mild dysplasia to invasive carcinoma. Epithelia were classified as follows: type 1, keratinized thick stratified (gingiva, hard palate, dorsal tongue); type 2a, non-keratinized thin stratified (floor of mouth, vestibule, ventral tongue, soft palate, palatine tonsils, base of tongue); type 2b, non-keratinized, very thick stratified (retromolar trigon, lateral tongue, labial and buccal mucosa). Histopathology revealed 32 % benign lesions, 13 % mild to moderate dysplasias, 15 % severe dysplasias/carcinoma in situ, 16 % microinvasive, and 23 % invasive carcinomas. The false positive rates were 32 % at COE, 27 % at WL, and 15 % at NBI. The false negative rates were 49, 22, and 11 %, respectively. Diagnositic performance was higher for NBI compared to COE (p < 0.001) and to WL (p = 0.004). Comparison of the diagnostic value of NBI among different OC/OP subsites did not show statistically significant difference. NBI as an "optical biopsy" tool significantly reduces the rates of false positives and false negatives in diagnosis of OC/OP cancer compared with COE and WL. No statistically significant difference was noted in its diagnostic value among different OC/OP subsites.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy. ceceplaza@libero.it.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Bon
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Paderno
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Grazioli
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Perotti
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Barbieri
authors.affiliation: Department of Oral Medicine, Dental Clinic, University of Brescia, Brescia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Majorana
authors.affiliation: Department of Oral Medicine, Dental Clinic, University of Brescia, Brescia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bardellini
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D062048:Narrow Band Imaging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055815:Young Adult
keywords: Narrow band imaging; Optical biopsy; Oral cancer; Oropharyngeal cancer; Squamous cell cancer