Hostname: page-component-669899f699-ggqkh Total loading time: 0 Render date: 2025-05-02T00:06:53.110Z Has data issue: false hasContentIssue false
  • English
  • Français

Correlation of narrow-band imaging findings using the Ni and European Laryngeal Society classification systems during in-office flexible laryngoscopy with histopathology

Published online by Cambridge University Press:  19 June 2023

Nupur Kapoor Nerurkar Open the ORCID record for Nupur Kapoor Nerurkar [Opens in a new window]  and
Asitama Sarkar
Nupur Kapoor Nerurkar*
Affiliation:
Bombay Hospital Voice and Swallowing Centre, Bombay Hospital and Medical Research Centre, Mumbai, India
Asitama Sarkar
Affiliation:
Bombay Hospital Voice and Swallowing Centre, Bombay Hospital and Medical Research Centre, Mumbai, India
*
Corresponding author: Nupur Kapoor Nerurkar; Email: [email protected] Fax: 91 22 2208 0871
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study used the European Laryngeal Society (2016) and Ni (2011 and 2019) classifications for narrow-band imaging and correlated the findings with histopathology.

Methods

Retrospective analysis was conducted by retrieving data of patients who underwent micro-laryngoscopy for suspicious glottic lesions. The narrow-band imaging findings were classified using both classification systems. Retrieved histopathology report findings were correlated with narrow-band imaging data.

Results

Using the European Laryngeal Society and Ni classifications, 37 (69.8 per cent) and 35 (66 per cent) patients, respectively, were suspected to have malignant lesions. Upon histopathology, 37 (69.8 per cent) lesions were malignant. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy using the European Laryngeal Society classification were 91.9 per cent, 81.3 per cent, 91.9 per cent, 81.3 per cent and 88.7 per cent, and using the Ni classification were 91.9 per cent, 93.8 per cent, 97.1 per cent, 83.3 per cent and 92.5 per cent, respectively.

Conclusion

The Ni classification had better specificity and accuracy. The European Laryngeal Society classification is simple to use and may serve as a useful screening tool. For optimum results, both European Laryngeal Society and Ni classifications may be used together, in that order.

Keywords

Head and neck cancersurgerydiagnosisvoicelarynxairwaylaryngologystridorlaryngomalaciapediatricsotorhinolaryngologysurgical diagnostic techniquesendoscopy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 2 , February 2024 , pp. 203 - 207
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Nupur Nerurkar takes responsibility for the integrity of the content of the paper

References

Gono, K, Obi, T, Yamaguchi, M, Ohyama, N, Machida, H, Sano, Y et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 2004;9:568–77CrossRefGoogle ScholarPubMed
Ni, XG, He, S, Xu, ZG, Gao, L, Lu, N, Yuan, Z et al. Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol 2011;125:288–96CrossRefGoogle ScholarPubMed
Inoue, H, Kumagai, Y, Yoshida, T, Kawano, T, Endo, M, Iwai, T. High-magnification endoscopic diagnosis of the superficial esophageal cancer. Dig Endosc 2000;12:32–5CrossRefGoogle Scholar
Kumagai, Y, Inoue, H, Nagai, K, Kawano, T, Iwai, T. Magnifying endoscopy, stereoscopic microscopy, and the microvascular architecture of superficial esophageal carcinoma. Endoscopy 2002;34:369–75CrossRefGoogle ScholarPubMed
Yoshida, T, Inoue, H, Usui, S, Satodate, H, Fukami, N, Kudo, SE. Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions. Gastrointest Endosc 2004;59:288–95CrossRefGoogle ScholarPubMed
Kraft, M, Fostiropoulos, K, Gürtler, N, Arnoux, A, Davaris, N, Arens, C. Value of narrow band imaging in the early diagnosis of laryngeal cancer. Head Neck 2016;38:15–20CrossRefGoogle ScholarPubMed
Piazza, C, Del Bon, F, Peretti, G, Nicolai, P. Narrow band imaging in endoscopic evaluation of the larynx. Curr Opin Otolaryngol Head Neck Surg 2012;20:472–6CrossRefGoogle ScholarPubMed
Arens, C, Piazza, C, Andrea, M, Dikkers, FG, Tjon Pian Gi, RE, Voigt-Zimmermann, S et al. Proposal for a descriptive guideline of vascular changes in lesions of the vocal folds by the committee on endoscopic laryngeal imaging of the European Laryngological Society. Eur Arch Otorhinolaryngol 2016;273:1207–14CrossRefGoogle Scholar
Arens, C, Glanz, H, Dreyer, T, Malzahn, K. Compact endoscopy of the larynx. Ann Otol Rhinol Laryngol 2003;112:113–19CrossRefGoogle ScholarPubMed
Ni, XG, Zhu, JQ, Zhang, QQ, Zhang, BG, Wang, GQ. Diagnosis of vocal cord leukoplakia: the role of a novel narrow band imaging endoscopic classification. Laryngoscope 2019;129:429–34CrossRefGoogle ScholarPubMed
Lee, DH, Yoon, TM, Lee, JK, Lim, SC. Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia. Eur Arch Otorhinolaryngol 2015;272:1719–24CrossRefGoogle ScholarPubMed
Lin, C, Zhang, S, Lu, L, Wang, M, Qian, X. Diagnostic value and pathological correlation of narrow band imaging classification in laryngeal lesions. Ear Nose Throat J 2021;100:737–41CrossRefGoogle ScholarPubMed
Tan, NC, Herd, MK, Brennan, PA, Puxeddu, R. The role of narrow band imaging in early detection of head and neck cancer. Br J Oral Maxillofac Surg 2012;50:132–6CrossRefGoogle ScholarPubMed
Fujii, S, Yamazaki, M, Muto, M, Ochiai, A. Microvascular irregularities are associated with composition of squamous epithelial lesions and correlate with subepithelial invasion of superficial type pharyngeal squamous cell carcinoma. Histopathology 2010;56:510–22CrossRefGoogle ScholarPubMed
Bertino, G, Cacciola, S, Fernandes, WB Jr, Fernandes, CM, Occhini, A, Tinelli, C et al. Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: validation of a new endoscopic clinical classification. Head Neck 2015;37:215–22CrossRefGoogle ScholarPubMed
Klimza, H, Jackowska, J, Tokarski, M, Piersiala, K, Wierzbicka, M. Narrow-band imaging (NBI) for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect. PLoS One 2017;12:e0180590CrossRefGoogle ScholarPubMed
Ahmadzada, S, Vasan, K, Sritharan, N, Singh, N, Smith, M, Hull, I et al. Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: systematic review and meta-analysis. Head Neck 2020;42:3427–37CrossRefGoogle ScholarPubMed
Šifrer, R, Rijken, JA, Leemans, CR, Eerenstein, SEJ, van Weert, S, Hendrickx, JJ et al. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society. Eur Arch Otorhinolaryngol 2018;275:147–51CrossRefGoogle ScholarPubMed
Šifrer, R, Šereg-Bahar, M, Gale, N, Hočevar-Boltežar, I. The diagnostic value of perpendicular vascular patterns of vocal cords defined by narrow-band imaging. Eur Arch Otorhinolaryngol 2020;277:1715–23CrossRefGoogle ScholarPubMed
Altman, KW. Vocal fold masses. Otolaryngol Clin North Am 2007;40:1091–108CrossRefGoogle ScholarPubMed