The Role of NBI HDTV Magnifying Endoscopy in the Prehistologic Diagnosis of Laryngeal Papillomatosis and Spinocellular Cancer

Abstract

Narrow band imaging (NBI) HDTV (high definition television) magnifying endoscopy is considered to be superior for the accurate display of the microvascular patterns of superficial mucosal lesions. Observation of changes in intraepithelial papillary capillary loops (IPCL) can help distinguish benign from malignant lesions as part of an “optical biopsy.” However, IPCL changes in papillomas may be mistaken for spinocellular cancer (SCC). The aim of the study was to determine whether observing microvascular changes alone is sufficient for discriminating between laryngeal SCC and papillomatosis. An additional aim was to identify associated characteristics that could clarify the diagnosis. The study included 109 patients with a suspected laryngeal tumor or papilloma. HDTV NBI magnifying endoscopy was performed during direct laryngoscopy. It was possible to visualize IPCL changes in 82 out of 109 patients (75.2%). In 71 (86.6%) patients, the diagnosis was correctly determined. In 4 (4.9%) cases, the diagnosis of SCC was expressed on the basis of finding pathologic IPCL, but histology did not demonstrate malignancy. To achieve a correct diagnosis using HDTV NBI magnifying endoscopy, it is important not only to observe changes in the shape of IPCL but also to note possible papillary structures with central-axis capillaries typical of papillomatosis.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

“…Nevertheless, there is no ultrathin, zooming, flexible videoendoscope available for ENT purposes; therefore, a combination of rigid telescopes and an HDTV camera head must be used to achieve sufficient resolution and ultrahigh magnification (150). Although most authors concur that NBI with or without HDTV is a valid diagnostic tool, this method has some limitations.…”

“…The NBI filter sets (415 nm, which is the hemoglobin absorption band, and 540 nm) are selected to obtain fine images of microvascular structures of different types tissue, which are necessary for diagnosing a tumor at early stage. (150), and that some of the associated endoscopic characteristics to each single laryngeal lesions, such as the surface, the presence of multiple lesions, and the spread to both vocal cords, may be taken as the criteria used for a more accurate diagnosis.…”

Use of Narrow Spectral Endoscopy Method in Diagnostics of Malignant Larynx Diseases: Literature Review Nand Clinical Obsevrations

“…поставили цель определить различия между карциномой и папилломатозом гортани при интра-операционном NBI-обследовании. Несмотря на то что они использовали эндоскоп с 150 кратным увеличени-ем, выводом явилось то, что основное отличие заключается в клинической картине: признаки неоангиогенеза, выявляемые в режиме NBI, и макро-скопические признаки папилломато-за [14].…”

Value of Narrow Band Imaging Endoscopy in Detection of Early Laryngeal Squamous Cell Carcinoma

“…Výhodou metody NBI endoskopie je možnost ambulantního provedení, snadné vyšetření s možností zpětné analýzy záznamu v krátkém časovém intervalu. NBI endoskopie přináší výborné výsledky v pří-padě čistého povrchu pozorované sliznice, nicméně má i své limity [4]. Metoda není vhodná při přítomnosti nekrotické tkáně na povrchu sliznice, při bělavých plochách kryjících lézi, při stagnaci sekretu nebo u poradiačních změn na sliznicích, které znemožňují správně hodnotit slizniční cévní pleteně a mohou tak vést k falešně negativním výsledkům [6].…”

“…NBI endoskopii lze tedy zařadit mezi metody tzv. před-histologické dia gnostiky slizničních změn [4,5]. …”