Application Of Narrow Band Imaging Endoscopy In The Diagnosis Of Pharynx And Larynx Mass

Objective:By comparing the difference between narrow band imaging endoscopy(NBI)and common white light endoscopy results in the diagnosis of pharynx and larynx mass,the diagnostic value and clinical significance of narrow band imaging endoscopy in the diagnosis of benign and malignant diseases of throat were evaluated.Method:Collect 2018.10-2020.01 otorhinolaryngology patients who compliance with inclusion criteria of pharynx and larynx mass in Yan’an University affiliated hospital,Perform narrow band imaging endoscopy and general white light endoscopy.On the basis of the classification NBI throat lesions summarized by Professor Ni Xiaoguang,the benign and malignant lesions were predicted by observing the intraepithelial papillary capillary loop(IPCL)on the mucosal surface of pharynx and larynx mass,Predicting and judging benign and malignant lesions,upward bulge and downward invasive lesions,polyps,cysts,leukoplakia,papilloma,carcinoma in situ and invasive carcinoma.Pathological results as the gold standard,the detection rate,accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the two inspection methods were used as the main evaluation indexes to compare the differences between the two methods.Result:In this study,112 patients with pharynx and larynx mass were selected,including 89 males and 23 females.There were 40 benign lesions(20 cysts,20 polyps),40 precancerous lesions(20 leukoplakia,20 papillomas)and 39 malignant lesions(9 carcinoma in situ,30 invasive cancers).For benign lesions,the detection rates were 29.41% and 31.09% in the common white-light endoscopy group and narrow-band imaging endoscopy group.the accuracy was 87.39% and 94.12%,the sensitivity was 87.50% and 92.50%,the specificity was 87.34% and 94.94%,positive predictive values were 77.78% and 90.24%,negative predictive values were 93.24% and 96.15%,respectively.the P values >0.05,the difference was not statistically significant.For precancerous lesions,the detection rates of common white light endoscopy group and narrow band imaging endoscopy group were 20.17% and 27.73%,respectively.the P value >0.05,and the difference was not statistically significant.The accuracy was 73.95% and 92.44%,the sensitivity was 60.00% and 82.50%,the specificity was 81.01% and 97.47%,the positive predictive value was 61.54% and 94.29%,the negative predictive value was 80.00% and 91.67%,respectively,and the P value <0.05,the difference was statistically significant.For malignant lesions,the detection rate of common white light endoscopy group and narrow band imaging endoscopy group were 19.33% and 30.25%,the accuracy rate was 76.47% and 91.60%,the sensitivity was 58.97% and 92.31%,the negative predictive value was 81.93% and 96.05%,the P value <0.05%,the difference was statistically significant,the specificity was 85.00% and 91.25%,the positive predictive value was 65.71% and 83.72%,respectively,and P value >0.05,the difference was not statistically significant.For downward invasive lesions,the detection rate of common white light endoscopy group and narrow band imaging endoscopy group are 13.16% and 39.47%,the accuracy rate are 60.53% and 86.84%,the sensitivity are 31.25% and 93.75%,the negative predictive value are 62.07% and 94.74%,the P value <0.05,the difference was statistically significant,the positive predictive value are 55.56% and 78.95%,the P value>0.05,The difference is not statistically significant,and the specificity of both approaches are 81.82%.For upwardly bulging lesions,The detection rate of common white light endoscopy group and narrow band imaging endoscopy group are 22.22% and 25.93%,The accuracy are 83.95 and 93.83%,the sensitivity was 78.26% and 91.30%,the specificity was 86.21% and 94.83%,the positive predictive value was 69.23% and 87.50%,the negative predictive value was 90.91% and 96.49%,respectively,and the P value >0.05,the difference was not statistically significant.The diagnostic accuracy of common white light endoscopy and narrow band imaging endoscopy for polyps was 80.00% and 95.00%,the diagnostic accuracy of cyst was 95.00% and 90.00%,and the diagnostic accuracy of leukoplakia was 55.00% and 70.00%,respectively.P values >0.05,but the difference was not statistically significant.The diagnostic accuracy of the two groups was 65.00% and 95.00% for papilloma,33.33% and 88.89% for carcinoma in situ,66.66% and 93.33% for invasive carcinoma,respectively.P values <0.05,the difference was statistically significant.Conclusion:1.By observing the IPCL structure and morphology of the mucosal surface of pharynx and larynx mass,narrow band imaging endoscopy can detect early cancer and precancerous lesions located on the mucosal surface.2.There is no significant difference between the two diagnostic methods for benign pharyngeal lesions.For precancerous lesions and malignant lesions,narrow band imaging endoscopy has obvious advantages over common white light endoscopy.3.When precancerous lesions and early carcinogenesis have not caused significant morphological changes or downward invasive lesions,narrow band imaging endoscopy has more advantages than white light endoscopy.When the lesion has obvious morphological changes or is an upwardly ascending lesion,The difference between the two diagnostic methods was not obvious.4.For throat polyps,cysts,leukoplakia,there is no significant difference between the two diagnostic methods;for papilloma,carcinoma in situ,invasive cancer,narrow band imaging endoscopy can improve its diagnostic accuracy.