title: Narrow band imaging as screening test for early detection of laryngeal cancer: a prospective study.
abstract: OBJECTIVE
  To analyse the specificity and sensibility of narrow band imaging illumination technology in the early detection of laryngeal cancer in the patients' population without previous diagnosis of laryngeal cancer in a screening setting.
  
  
  METHODS
  Unicentre, prospective study.
  
  
  METHODS
  One tertiary medical centre.
  
  
  METHODS
  A total of 158 patients completed all protocol steps.
  
  
  METHODS
  Sensitivity, specificity, positive and negative predictive values of narrow band imaging (NBI) in detecting precancerous lesions and early laryngeal cancer.
  
  
  RESULTS
  The blind assessment of NBI patterns concurred in 90% of patients. In identifying laryngeal cancer and its precursor lesions, in-office NBI showed a high sensitivity of 97% (CI, 84.2%-99.9%), specificity of 92.5% (CI, 79.6%-98.4%), PPV of 91.4% (CI, 76.9%-98.2%), NPV of 97.4% (CI, 86.2%-99.9%) and accuracy of 94.5% but intra-operative NBI demonstrated a sensitivity of 97% (CI, 84.2%-99.9%), a slightly higher specificity of 95% (CI, 83.1%-99.4%), PPV of 94.1% (CI, 80.3%-993%), NPV of 97.4% (CI, 86.5%-99.9%) and accuracy of 95.9%. The comparative receiver operating characteristic curves confirmed a slightly higher performance for the intra-operative NBI evaluation without any statistical significance (P = 0.41).
  
  
  CONCLUSIONS
  Our results confirm the high values of sensitivity and specificity of NBI system in detecting pre-neoplastic laryngeal lesions or early laryngeal cancer in a patients' population selected only by means of risk factors exposure and confirmed the potential role of NBI evaluation as in-office screening tool.
authors.affiliation: Head and Neck Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Vito
authors.affiliation: Head and Neck Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Meccariello
authors.affiliation: Head and Neck Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Vicini
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D062048:Narrow Band Imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity