Early Detection of Superficial Squamous Cell Carcinoma in the Head and Neck Region and Esophagus by Narrow Band Imaging: A Multicenter Randomized Controlled Trial
Early Detection of Superficial Squamous Cell Carcinoma in the Head and Neck Region and Esophagus by Narrow Band Imaging: A Multicenter Randomized Controlled Trial
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DOI：
10.1200/jco.2009.25.4680
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发表时间：
2010-03-20
影响因子：
45.3
通讯作者：
Saito, Daizo
中科院分区：
文献类型：
--
作者：
Muto, Manabu;Minashi, Keiko;Saito, Daizo
目的：大多数食管鳞状细胞癌（ESCCs）和头颈部癌（H&N）在晚期才被诊断出来。为了提高生存率，早期发现是必要的。我们比较了传统白光成像（WLI）和窄带成像（NBI）对高危患者这些区域浅表癌的实时诊断率。在一项多中心、前瞻性、随机对照试验中，320例ESCC患者被随机分配到原发性WLI + NBI组（n = 162）或原发性NBI + WLI组（n = 158）。主要目的是比较WLI和NBI在H&N区和食道浅表癌的实时检出率。第二个目的是评估这些技术的诊断准确性。结果snbi在H&N区和食道的浅表癌检出率均高于WLI （100% vs 8%, P < 0.001; 97% vs 55%, P < 0.001）。NBI对浅表癌诊断的敏感性在H&N区为100%，在食管为97.2%。NBI诊断浅表癌的准确率分别为86.7%和88.9%。NBI在这两个区域的敏感性和准确性均显著高于WLI （H&N区域的P < 0.001和P = 0.02；食道的两种测量方法分别P < 0.001）。结论nbi可作为早期发现H&N区及食道浅表癌的标准检查。
PurposeMost of the esophageal squamous cell carcinomas (ESCCs) and cancers of the head and neck (H&N) region are diagnosed at later stages. To achieve better survival, early detection is necessary. We compared the real-time diagnostic yield of superficial cancer in these regions between conventional white light imaging (WLI) and narrow band imaging (NBI) in high-risk patients.Patients and MethodsIn a multicenter, prospective, randomized controlled trial, 320 patients with ESCC were randomly assigned to primary WLI followed by NBI (n = 162) or primary NBI followed by WLI (n = 158) in a back-to-back fashion. The primary aim was to compare the real-time detection rates of superficial cancer in the H&N region and the esophagus between WLI and NBI. The secondary aim was to evaluate the diagnostic accuracy of these techniques.ResultsNBI detected superficial cancer more frequently than did WLI in both the H&N region and the esophagus (100% v 8%, P < .001; 97% v 55%, P < .001, respectively). The sensitivity of NBI for diagnosis of superficial cancer was 100% and 97.2% in the H&N region and the esophagus, respectively. The accuracy of NBI for diagnosis of superficial cancer was 86.7% and 88.9% in these regions, respectively. The sensitivity and accuracy were significantly higher using NBI than WLI in both regions (P < .001 and P = .02 for the H&N region; P < .001 for both measures for the esophagus, respectively).ConclusionNBI could be the standard examination for the early detection of superficial cancer in the H&N region and the esophagus.