Narrow-band imaging endoscopy with magnification is useful for detecting metachronous superficial pharyngeal cancer in patients with esophageal squamous cell carcinoma
Narrow-band imaging endoscopy with magnification is useful for detecting metachronous superficial pharyngeal cancer in patients with esophageal squamous cell carcinoma
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DOI：
10.1111/j.1440-1746.2009.05993.x
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发表时间：
2010-02-01
影响因子：
4.1
通讯作者：
Saito, Daizo
中科院分区：
文献类型：
--
作者：
Nonaka, Satoru;Saito, Yutaka;Saito, Daizo
背景和目标：头颈部癌症，特别是咽部癌症，以及食管癌经常同时或异时共存，但大多数咽部癌症病例在晚期被检测到，导致预后不良。本研究的目的是评估在食管鳞状细胞癌（SCC）治疗后，使用窄带成像（NBI）内镜放大对早期发现咽癌的有效性。方法：该病例系列于2005年4月至10月在东京国立癌症中心医院进行，包括424名连续患者进行监测内窥镜检查，既往接受过放化疗（CRT）和/或手术治疗食管SCC。随机对91例患者进行NBI内镜下咽部放大观察（NBI组）和333例使用传统白色光内镜的患者结果：NBI放大内镜对咽癌的检出率明显高于对照组与传统内镜检查（1.2%; 4/333）比较，差异有显著性（P < 0.0001）。NBI组CRT患者的检出率（12.9%; 7/54）显著高于对照组（0.5%; 1/191）（P < 0.0001）。NBI组的诊断敏感性、特异性、准确性、阳性预测值和阴性预测值分别为100%（10/10）、97.5%（79/81）、97.8%（89/91）、83.3%（10/12）和100%（79/79）。NBI内窥镜放大是一种有前途的技术，用于早期检测食管鳞状细胞癌患者的浅表性咽癌。
Background and Aims: Head and neck cancers, especially pharyngeal cancers, as well as esophageal cancers frequently coexist either synchronously or metachronously, but most cases of pharyngeal cancer are detected at an advanced stage resulting in poor prognosis. The aim of this study is to evaluate the effectiveness of using narrow-band imaging (NBI) endoscopy with magnification for early detection of pharyngeal cancer on patients following their treatment for esophageal squamous cell carcinoma (SCC).Methods: This case series was conducted at the National Cancer Center Hospital in Tokyo between April and October 2005 and included 424 consecutive patients for surveillance endoscopy who had previously undergone chemoradiotherapy (CRT) and/or surgery for esophageal SCC. Observation of the pharyngeal region was randomly conducted on 91 patients using NBI endoscopy with magnification (NBI group) and 333 patients using conventional white light endoscopy (control group).Results: The detection rate for pharyngeal cancer was significantly higher using NBI endoscopy with magnification (10.9%; 10/91) compared with conventional endoscopy (1.2%; 4/333) (P < 0.0001). In particular, the detection rate in CRT patients was significantly higher in the NBI group (12.9%; 7/54) than the control group (0.5%; 1/191) (P < 0.0001). In addition, diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the NBI group were 100% (10/10), 97.5% (79/81), 97.8% (89/91), 83.3% (10/12) and 100% (79/79), respectively.Conclusion: NBI endoscopy with magnification is a promising technique for detecting superficial pharyngeal cancer at an early stage in patients previously treated for esophageal SCC.