The Clinical Value Of Narrow-band Imaging Endoscopy In Diagnosis Of Early Laryngeal Cancer And Precancerous Lesions

Objective This study is to investigate the clinical value of narrow-band imaging endoscopy in diagnosis of early laryngeal cancer andprecancerous lesions.Methods:All the62patients who suffered throat tumors werecollected from the Otolaryngology-Head and Neck Surgery Departmentof China-Japan Union Hospital of Jilin University.from Apr.2011toFeb.2012.The patients were divided into two groups, video laryngoscopeexamine group and narrow-band imaging endoscopy examine(NBI)group. Among all the cases,the10polyp of vocal cord cases were set ascontrol group, and all the other52cases were sent for pathologicalexamination after the surgery. All the52cases were involved78anatomical partition, there were24lesions of the supraglottic area,14lesions of the glottic and22subglottic lesions including20cases ofmoderate to severe dysplasia,3cases of papilloma, the rest were55casesof squamous cell carcinoma.NBI endoscopic is designed with the application of zoom and opticalenhancement technology, which can facilitate a better observation of themucosal surface of microvascular morphology and structure. NBI utilizevideo endoscope system in the narrow band width filter, instead of thetraditional broadband filtration, with the application of a special filter anda white xenon light source. The white xenon light source can be issue red,green, and blue light components. NBI system can filtrate the longestwavelength red light, and release the blue component (415nm) and greeningredients (540nm), as the illumination of the endoscope. Hemoglobinabsorb the blue light, usually at415nm, Blue-ray hemoglobin fullyabsorbed, appear as dark, enhanced imaging post micro vascular fine structure and organization of images of mucosal surfaces. NBI endoscopycan clearly show the shape and structure of the tiny blood vessels of themucosal surface. The system has conventional endoscopy and NBIendoscopy two operating modes, and the operation is simple and easy tounderstand. With NBI endoscopy mode, observation of morphologicalchanges of the fine blood vessels on the surface of mucosa can beachieved, clearly showing the small lesions of the mucosa surface,increasing the accuracy rate of the identification of tumor lesions andnon-neoplastic lesions, so that the out-patient endoscopylesion detectionrate and diagnostic accuracy can be significantly increased.With the use of laryngoscope and NBI, the condition of mucosa andsubmucosa vascular at the boundary between throat lesions and normaltissue were studied. The tissues for pathological examination werecollected under NBI.Results:1. NBI can display the laryngeal mucosa intraepithelial papillarycapillary loop (IPCL) structures much better than the ordinary fiberlaryngoscope dose.2. With the use of NBI, normal tissue, atypical hyperplasia andtumor like tissue can be identified according to the different structure ofIPCL.3. The NBI endoscopy can significantly increase the detection rateof precancerous lesions than ordinary white light electrical laryngoscope.Conclusions: The NBI is the latest, newly developed non-invesiveendoscopes imagine diagnosis technique with its ability of clearlyshowing normal tissue and tiny structure change within the laryngealmucosa IPCL. The NBI technique has a great advantage in predicting theresults of histopathology and increasing the accuracy rate of earlydiagnosis and biopsy targeting.