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

  • Muto M
  • Minashi K
  • Yano T
 et al. 
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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.

Author-supplied keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell/*diagnosis
  • Early Detection of Cancer/*methods
  • Endoscopy/*methods
  • Esophageal Neoplasms/*diagnosis
  • Female
  • Head and Neck Neoplasms/*diagnosis
  • Humans
  • Hypopharyngeal Neoplasms/diagnosis
  • Image Enhancement
  • Male
  • Middle Aged
  • Optical Devices
  • Oropharyngeal Neoplasms/diagnosis
  • Precancerous Conditions/*diagnosis

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  • M Muto

  • K Minashi

  • T Yano

  • Y Saito

  • I Oda

  • S Nonaka

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