Document Detail

Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers.
MedLine Citation:
PMID:  20669074     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIM: Although narrow-band imaging (NBI) in endoscopy can improve detection of early-stage esophageal malignancies in patients with head and neck cancers, false-positive results may be obtained in areas with nonspecific inflammatory changes. This study evaluated the feasibility of primary screening with NBI and magnification for the presence of esophageal malignancies in these cancer patients. PATIENTS AND METHODS: Sixty-nine patients with documented head and neck cancers were enrolled from April 2008 to January 2009. All patients underwent a meticulous endoscopic examination of the esophagus using a conventional white-light system followed by re-examination using the NBI system and final confirmation with NBI plus magnification. RESULTS: Twenty-one patients (30.4 %) were confirmed to have esophageal neoplasia. Among these 21, 16 (76.2 %) had synchronous lesions, 9 (42.9 %) were asymptomatic, and 10 (47.6 %) had early-stage neoplasia. The incidence of multiple esophageal neoplasia was 57.1 %. NBI was more effective than conventional endoscopy in detecting neoplastic lesions (35 lesions in 21 patients vs. 22 lesions in 18 patients) and was particularly effective in patients with dysplasia (13 lesions in 9 patients vs. 3 lesions in 3 patients). The sensitivity and accuracy of detection were 62.9 % and 64.4 % for conventional endoscopy, 100 % and 86.7 % for NBI alone, and 100 % and 95.6 % for NBI with high magnification, respectively. CONCLUSIONS: Compared with current approaches, NBI followed by high magnification significantly increases the accuracy of detection of esophageal neoplasia in patients with head and neck cancers. The result warrants conducting prospective randomized controlled study to confirm its efficacy.
C T Lee; C Y Chang; Y C Lee; C M Tai; W L Wang; P H Tseng; J C Hwang; T Z Hwang; C C Wang; J T Lin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-28
Journal Detail:
Title:  Endoscopy     Volume:  42     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  613-9     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart . New York.
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
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MeSH Terms
Carcinoma, Squamous Cell / diagnosis*,  pathology
Early Detection of Cancer / methods*
Esophageal Neoplasms / diagnosis*,  epidemiology,  pathology
Esophagitis / diagnosis*,  pathology
Esophagoscopy / methods*
Head and Neck Neoplasms / diagnosis
Image Enhancement / methods*
Middle Aged
Neoplasms, Multiple Primary / diagnosis*,  epidemiology
Sensitivity and Specificity

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