Value of Narrow Band Imaging (NBI) in Management of Leukoplakia


Authors: L. Staníková 1;  H. Kučová 1;  R. Walderová 1;  K. Zeleník 1,2;  P. Komínek 1,2
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku, Fakultní nemocnice Ostrava 1;  Ostravská univerzita, Lékařská fakulta, Katedra kraniofaciálních oborů, Ostrava 2
Published in: Otorinolaryng. a Foniat. /Prague/, 64, 2015, No. 4, pp. 186-190.
Category: Original Papers

Overview

Aim:
To investigate the impact of Narrow Band Imaging (NBI) in prehistological in vivo diagnostic of laryngeal leukoplakia.

Materials and methods:
One hundred twenty-six patients were investigated using white light HD laryngoscopy and Narrow Band Imaging in 6/2013-6/2015. Indication criteria included: chronic laryngitis, hoarseness more than 3 weeks or macroscopic laryngeal lesion. Twenty-six patients with a flat laryngeal leukoplakia were enrolled to the study. Patients were divided to 2 groups – group I (malign intraepithelial papillary capillary loop (IPCL) changes, viewed using NBI endoscopy around the leukoplakia) and group II (leukoplakia with surrounding benign vascular network by NBI endoscopy). Pathological IPCL (group I) were evaluated by histological examination, results were compared with pre histological NBI diagnosis. Benign vascular network surrounding of leukoplakia was checked by NBI endoscopy after 2-3 months, extension of leukoplakia and capillary changes were evaluated. In cases of leukoplakia growth progression or new pathologic IPCL changes histological examination was indicated in these lesions.

Results:
7/26 (26.9%) patients were enrolled to group I, 19/26 (73.1%) to the group II. In group I all 7/7 patients were histologically investigated – carcinoma in situ or invasive squamous cell carcinoma were confirmed in 5/7 cases (71.4%). In group II progression of leukoplakia growth were reported by check NBI endoscopy in 11/19 (57.9%) cases, in those cases histologically hyperkeratosis or low-grade dysplasia were approved, squamous cell carcinoma was not confirmed in any case. In other patients in group II (8/19, 42.1%) the same extension of lesion or regression of leukoplakia were detected by NBI endoscopy.

Conclusion:
Macroscopic appearance of leukoplakia could be variable in white light, so using Narrow Band Imaging is convenient to improve the evaluation of flat laryngeal leukoplakias based on optic pre histological diagnostics. Narrow correlation between NBI features and results of histological examination leads to the conclusion, that lesion with negative NBI endoscopy may be indicated to long-term endoscopy follow-up without histological evaluation.

Keywords:
leukoplakia, squamous cell carcinoma of larynx, narrow band imaging, endoscopy


Sources

1. Avila, D. D., D´Ávila, J., Góis, C. et al.: Premalignant laryngeal lesions: Twenty-year experience in specialized service. Arch. Otorhinolaryngol., 18, 2014, s. 352-356.

2. Bartlett, R. S., Heckman, W. W., Isenberg, J. et al.: Genetic characterization of vocal fold lesions: leukoplakia and carcinoma. Laryngoscope, 122, 2012, 2, s. 336-342.

3. Bouquot, J. E., Gnepp, D. R.: Laryngeal precancer: a review of the literature commentary and comparison with oral leukoplakia, Head Neck, 13, 1991, 6, s. 488-497.

4. Gale, N., Michaels, L., Luzar, B. et al.: Current review on squamous intraepithelial lesions of the larynx. Histopathology, 54, 2009, 6, s. 639-656. doi: 10.1111/j.1365-2559.2008.03111.x. Epub 2008 Aug 25.

5. Gallo, A., De Vincentiis, M., Della Rocca, C. et al.: Evolution of precancerous laryngeal lesions: a clinicopathological study with long-term follow-up on 259 patients. Head Neck, 23, 2001, s. 42-47.

6. Isenberg, J. S., Crozier, D. L., Dailey, S. H.: Institutional and comprehensive review of laryngeal leukoplakia. Ann. Otol. Rhinol. Laryngol., 117, 2008, 1, s. 74-79.

7. Kleinsasser O.: Die Klassification und differential Diagnose der Epithelyperplasien der Kehlkopfschleimhaut auf Grund Histomorphologischer Merkmale (II). Zschr Laryng. Rhinol., 42, 1963, s. 339.

8. Lee, D. H., Yoon, T. M., Lee, J. K. et al.: Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia. Eur. Arch. Otorhinolaryngol., 272, 2015, s. 1719-1724. DOI 10.1007/s00405-015-3587-8

9. Lukeš, P., Zábrodský, M., Lukešová, E. et al.: The role of NBI HDTV Magnifying endoscopy in the prehistologic diagnosis of laryngeal papillomatosis and spinocellular cancer. Biomed. Res. Int., 2014, article ID 285486. doi: 10.1155/2014/285486. Epub 2014 Jun 17.

10. Malzahn, K., Dreyer, T., Glanz, H. et al.: Autofluorescence endoscopy in the diagnosis of early laryngeal cancer and its precursor lesions. Laryngoscope, 112, 2002, s. 488-493.

11. Ni, X. G., He, S., Xu, Z. G. et al.: Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J. Laryngál. Otol.,125, 2011, 3, s. 288-296.

12. Piazza, C., Cocco, D., De Benedetto, L. et al.: Narrow Band Imaging and high definition television in the assassment of laryngeal cancer: a prospective study on 279 patients. Eur. Arch. Otorhinolaryngol., 267, 2010, 3, s. 409-414.

13. Ricci, G., Molini, E., Faralli, M. et al.: Retrospective study on precancerous laryngeal lesions: long-term follow-up. Acta Otorhinolaryngol. Ital., 23, 2003, 5, s. 362-367.

14. Staníková, L., Kučová, H., Walderová, R. et al.: Využití Narrow Band Imaging v diagnostice časných karcinomů hrtanu. Klin. Onkol., 28, 2015, 2, s. 116-120.

15. Steinmetz, J., Rasmussen, L. S.: The elderly and general anesthesia. Minerva Anestesiol.. 76, 2010, 9, s. 745-752.

16. Watanabe, A., Taniguchi, M., Tsujie, H. et al.: The value of narrow band imaging for early detection of laryngeal cancer. Eur. Arch. Otorhinolaryngol., 266, 2009, 7, s. 1017-1023.

17. Yang, S. W., Lee, Y. Sh., Chang, L. Ch. et al.: Diagnostic significance of Narrow-Band Imaging for detecting high-grade dysplasia, carcinoma in situ, and carcinoma in oral leukoplakia. Laryngoscope, 122, 2012, s. 2754-2761.

18. Yang, S. W., Lee, Y. S., Chang, L. C. et al.: Light sources used in evaluating oral leukoplakia: broadband white light versus narrowband imaging. J. Oral Maxillofac. Surg., 42, 2013, s. 693-701.

19. Young, C. K., Lin, W. N., Lee, L. Y. et al.: Laryngoscopic characteristics in vocal leukoplakia: inter-rater reliability and correlation with histology grading. Laryngoscope, 125, 2015, 2, E62-66. doi: 10.1002/lary.24884. Epub 2014 Aug 14.

Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account