The value of flexible endoscopy with Narrow Band Imaging for the evaluation of recurrence of laryngeal and hypopharyngeal tumours after radiotherapy
Authors:
Jana Šatanková 1,2
; Anna Švejdová 1
; M. Vošmik 2,3
; Michal Černý 1,2
; P. Kordač 1
; Michal Homoláč 1
; Viktor Chrobok 1,2
Authors place of work:
Klinika otorinolaryngologie a chirurgie hlavy a krku, FN Hradec Králové
1; Univerzita Karlova, Lékařská fakulta v Hradci Králové
2; Klinika onkologie a radioterapie, FN Hradec Králové
3
Published in the journal:
Otorinolaryngol Foniatr, 70, 2021, No. 4, pp. 214-222.
Category:
Original Article
doi:
https://doi.org/10.48095/ccorl2021214
Summary
Background: The diagnosis of recurrent upper aerodigestive tumours is difficult, especially in the case of previous curative radiotherapy (RT) or chemoradiotherapy (CRT). Progress in the diagnostics of head and neck cancer came with the development of optical endoscopic imaging methods. The aim of this study was to analyse the benefits of flexible Narrow Band Imaging (NBI) in the visualization of suspected recurrence of malignancy in patients after curative RT (CRT). Methods: A total of 58 examined patients in follow-up after curative RT or CRT for laryngeal and hypopharyngeal squamous cell carcinoma were enrolled in the study. All patients underwent transnasal flexible endoscopy in conventional white light and NBI in local anaesthesia. Changes in microvascular architecture (intraepithelial papillary capillary loops – IPCL) have been classified according to Ni. IPCL I–III were considered to be non-suspicious, and therefore no histopathological examination was indicated. IV and V type findings were verified using HDTV NBI intraoperatively with biopsy sampling and subsequent histopathological correlation was performed. Results: Transnasal videoendoscopic examination with NBI revealed a suspicious finding (IPCL type IV and V) in 23/58 (39.7%) patients, non-suspicious finding (IPCL I–III) in 35/58 (60.3%). Histopathological examination verified the positive finding (precancerous or malignant changes) in 12/23 (52.2%) and negative finding in 11/23 (47.8%) cases. The sensitivity, specificity, positive and negative predictive value of flexible NBI endoscopy were 100%, 76.1%, 52.2% and 100% respectively. According to the Kappa index (K = 0.568), we proved a moderate concordance between flexible NBI endoscopy and histopathological results. Conclusions: Transnasal flexible endoscopy with NBI in outpatient settings contributes to an early detection of pathological changes also in post-radiation altered mucosa of the larynx and hypopharynx, while a correct interpretation of in NBI findings is required to reduce the incidence of false positive results.
Keywords:
squamous cell carcinoma – Larynx – radiotherapy – narrow band imaging – Ni classification – hypopharynx
Zdroje
1. Piazza C, Cocco D, De Benedetto L et al. Role of narrow-band imaging and high-definition television in the surveillance of head and neck squamous cell cancer after chemo- and/or radiotherapy. Eur Arch Otorhinolaryngol 2010; 267 (9): 1423–1428. Doi: 10.1007/s00405-010-1236-9.
2. Zbaren P, Caversaccio M, Thoeny HC et al. Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas. Otolaryngol Head Neck Surg 2006; 135 (6): 838–843. Doi: 10.1016/j.otohns.2006.06. 1264.
3. Watanabe A, Taniguchi M, Tsujie H et al. The value of narrow band imaging endoscope for early head and neck cancers. Otolaryngol Head Neck Surg 2008; 138 (4): 446–451. Doi: 10.1016/j.otohns.2007.12.034.
4. Goerres GW, Schmid DT, Bandhauer F et al. Positron emission tomography in the early follow-up of advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 2004; 130 (1): 105–109; discussion 120–101. Doi: 10.1001/archotol.130.1.105.
5. McGuirt WF, Greven KM, Keyes JW Jr. et al. Laryngeal radionecrosis versus recurrent cancer: a clinical approach. Ann Otol Rhinol Laryngol 1998; 107 (4): 293–296. Doi: 10.1177/000348 949810700406.
6. Vandecaveye V, De Keyzer F, Nuyts S et al. Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo) radiotherapy: correlation between radiologic and histopathologic findings. Int J Radiat Oncol Biol Phys 2007; 67 (4): 960–971. Doi: 10.1016/j.ijrobp.2006.09.020.
7. Lukeš P, Zábrodský M, Lukešová E et al. Narrow Band Imaging (NBI) – endoskopická metoda pro diagnostiku karcinomů hlavy a krku. Otorinolaryngol Foniatr 2013; 62 (4): 173–179.
8. Piazza C, Cocco D, Del Bon F et al. Narrow band imaging and high definition television in the endoscopic evaluation of upper aero-digestive tract cancer. Acta Otorhinolaryngol Ital 2011; 31 (2): 70–75.
9. Piazza C, Dessouky O, Peretti G et al. Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. Acta Otorhinolaryngol Ital 2008; 28 (2): 49–54.
10. Piazza C, Del Bon F, Peretti G et al. Narrow band imaging in endoscopic evaluation of the larynx. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (6): 472–476. Doi: 10.1097/ MOO.0b013e32835908ac.
11. Stanikova L, Satankova J, Kucova H et al. The role of narrow-band imaging (NBI) endoscopy in optical biopsy of vocal cord leukoplakia. Eur Arch Otorhinolaryngol 2017; 274 (1): 355–359. Doi: 10.1007/s00405-016-4244-6.
12. Ni XG, He S, Xu ZG et al. Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol 2011; 125 (3): 288–296. Doi: 10.1017/S00222 15110002033.
13. Sifrer R, Rijken JA, Leemans CR et al. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society. Eur Arch Otorhinolaryngol 2018; 275 (1): 147–151. Doi: 10.1007/s00405-017-4791-5.
14. Zabrodsky M, Lukes P, Lukesova E et al. The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy. Biomed Res Int 2014; 2014: 175398. Doi: 10.1155/2014/175 398.
15. Vilaseca I, Valls-Mateus M, Nogués A et al. Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions. Head Neck 2017; 39 (9): 1854–1863. Doi: 10.1002/hed.24849.
16. Nonaka S, Saito Y. Endoscopic diagnosis of pharyngeal carcinoma by NBI. Endoscopy 2008; 40 (4): 347–351. Doi: 10.1055/s-2007-995433.
17. Lin YC, Watanabe A, Chen WC et al. Narrow--band imaging for early detection of malignant tumors and radiation effect after treatment of head and neck cancer. Arch Otolaryngol Head Neck Surg 2010; 136 (3): 234–239. Doi: 10.1001/ archoto.2009.230.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2021 Číslo 4
Najčítanejšie v tomto čísle
- Course variations of the internal carotid artery and their significance in pharyngeal surgery
- Acute mastoiditis and intracranial complications in children
- Primary middle ear inverted papilloma – a case report
- Association between age-related hearing loss and cognitive impairment in ageing