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J Clin Oncol. 2010 Mar 20;28(9):1566-72. doi: 10.1200/JCO.2009.25.4680. Epub 2010 Feb 22.

Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial.

Author information

1
Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan. mmuto@kuhp.kyoto-u.ac.jp

Abstract

PURPOSE:

Most of the esophageal squamous cell carcinomas (ESCCs) and cancers of the head and neck (H&N) region are diagnosed at later stages. To achieve better survival, early detection is necessary. We compared the real-time diagnostic yield of superficial cancer in these regions between conventional white light imaging (WLI) and narrow band imaging (NBI) in high-risk patients.

PATIENTS AND METHODS:

In a multicenter, prospective, randomized controlled trial, 320 patients with ESCC were randomly assigned to primary WLI followed by NBI (n = 162) or primary NBI followed by WLI (n = 158) in a back-to-back fashion. The primary aim was to compare the real-time detection rates of superficial cancer in the H&N region and the esophagus between WLI and NBI. The secondary aim was to evaluate the diagnostic accuracy of these techniques.

RESULTS:

NBI detected superficial cancer more frequently than did WLI in both the H&N region and the esophagus (100% v 8%, P < .001; 97% v 55%, P < .001, respectively). The sensitivity of NBI for diagnosis of superficial cancer was 100% and 97.2% in the H&N region and the esophagus, respectively. The accuracy of NBI for diagnosis of superficial cancer was 86.7% and 88.9% in these regions, respectively. The sensitivity and accuracy were significantly higher using NBI than WLI in both regions (P < .001 and P = .02 for the H&N region; P < .001 for both measures for the esophagus, respectively).

CONCLUSION:

NBI could be the standard examination for the early detection of superficial cancer in the H&N region and the esophagus.

PMID:
20177025
PMCID:
PMC2849774
DOI:
10.1200/JCO.2009.25.4680
[Indexed for MEDLINE]
Free PMC Article

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