title: Narrow band imaging endoscopy of the nasopharynx is not more useful than white light endoscopy for suspected nasopharyngeal carcinoma.
abstract: Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on narrow band imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and narrow band imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on narrow band imaging endoscopy (=0.799). The sensitivity and specificity of white light and narrow band imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p < 0.0005, odds 58.978) and vascular tufts on narrow band imaging endoscopy (p = 0.020, odds 41.210). Narrow band imaging endoscopy of vasculature alone for suspected nasopharyngeal carcinoma is not more useful than white light endoscopy of nasopharyngeal morphology, nor does it add to or surpass the diagnostic accuracy of white light endoscopy in this regard.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong. lexvlantis@cuhk.edu.hk.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: John K S
authors.initials: JK
authors.lastname: Woo
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Michael C F
authors.initials: MC
authors.lastname: Tong
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Ann D
authors.initials: AD
authors.lastname: King
authors.affiliation: Division of Biostatistics, School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: William
authors.initials: W
authors.lastname: Goggins
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D009305:Nasopharynx / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Diagnosis; Endoscopy; Narrow band imaging; Nasopharyngeal carcinoma