Diagnostic value of narrow-band imaging laryngoscopy combined with laryngopharyngeal reflux scale for laryngeal carcinoma and precancerous lesions

Abstract

Objective To evaluate the value of narrow-band imaging (NBI) laryngoscopy combined with laryngopharyngeal reflux scale in the diagnosis of laryngeal malignant tumors and precancerous lesions. Methods A cross-sectional study was conducted on 96 patients (87 males and 9 females) with suspected laryngeal cancer or precancerous lesions under white light laryngoscope from December 2021 to April 2022. All patients were examined and compared with under white light mode and NBI mode of laryngoscopy as well as scored with reflux sign scale (reflux finding score, RFS). The reflux symptom index (RSI) scale was scored under the guidance of the same professional physician. White light mode, NBI mode, white light mode combined with throat reflux scale and NBI mode combined with throat reflux scale were used to evaluate the benign and malignant lesions. The pathological results of biopsy or operation were confirmed and regarded as diagnostic criteria. The accuracy, sensitivity and specificity in white light mode, NBI mode, white light mode combined RSI, and NBI mode combined RSI were compared, and the diagnostic effectiveness of the 4 Methods were analyzed and compared using receiver operating characteristic (ROC) pairing analysis and ROC curve analysis. Results Among the 96 patients, 20 cases were benign lesions, 33 cases were precancerous lesions and 43 cases were malignant lesions. The accuracy, sensitivity, and specificity was 71.88%, 60.47% and 81.13%, respectively, for the white light mode; was 92.71%, 90.70% and 94.34%, respectively in the NBI mode, was 83.33%, 81.40% and 84.91%, respectively, for white light mode combined with RSI; and was 92.71%, 95.35% and 90.57%, respectively for NBI mode combined with RSI. The average score of RFS corresponding to the 3 pathological grades (benign, precancerous and malignant lesions) were 4.20±0.68, 5.85±2.32 and 9.49±2.56 in white light mode, 4.50±0.92, 6.70±2.67 and 10.77±2.18 in NBI mode, and the score of RSI was 9.10±1.77, 10.88±2.22 and 12.40±2.86, respectively. The average score of RFS of NBI classification I-Vc were 4.31±0.61, 4.67±1.25, 6.23±3.07, 7.27±2.26, 10.16±2.68, 11.06±2.07 and 11.33±1.70, respectively. The average score of RSI was 9.08±1.59, 9.50±1.89, 10.15±2.32, 11.73±2.72, 12.21±2.67, 12.53±3.17 and 15.33±3.70, respectively. The accuracy, sensitivity and specificity of NBI mode were significantly higher than those of white light mode (P < 0.05); And so were white light model combined with laryngopharyngeal reflux scale than white light model (P < 0.05), but there was no statistical difference in specificity; There were no statistical differences in accuracy, sensitivity and specificity between NBI model and laryngopharyngeal reflux scale. The AUC difference between white light model and NBI, white light model and white light model combined with laryngeal reflux scale were -0.094 (95%CI: -0.167~-0.020) and -0.111 (95%CI: -0.178~-0.044), respectively (P < 0.05), which were statistically significant. Conclusion The diagnostic value of NBI model and white light model combined with laryngeal reflux scale is higher than that of white light model in laryngeal carcinoma and precancerous lesions.

Keywords

• narrow-band imaging
• electronic nasopharyngolarygoscopy
• laryngopharyngeal reflux scale
• laryngeal carcinoma
• precancerous lesions