Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2018
Laryngeal dysplasia and narrow band imaging: Secondary analysis of published data supports the role in patient follow-up.
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Paleri Vinidh, Sawant Rupali, Mehanna Hisham, Ainsworth Holly, Stocken Deborah
Аннотация
BACKGROUND: Clinicians have recognised the role of narrow band imaging (NBI) in the management of head and neck cancer in several studies. However, a recent systematic review was unable to pool the data on diagnostic efficacy in this setting owing to the heterogeneity in the published data.
METHODS: Secondary analysis of data, utilising Bayes' theorem, from meta-analyses and randomised trials.
RESULTS: In patients with a histological diagnosis of mild dysplasia who show no abnormalities on NBI, the post-test probability of malignancy is estimated to be 2.3%, compared to 10.3% with conventional white light imaging (WLI). For severe dysplasia, similar post-test probabilities after NBI and WLI are estimated to be 8.0% and 29.7%, respectively. Post-test probabilities in this setting indicate the chance of missing malignancy following a negative NBI or WLI in patients who undergo no further intervention. This study also provides a nomogram designed for use in this setting.
CONCLUSIONS: This study identifies the evidence base for use of NBI in the follow-up for laryngeal dysplasia.
METHODS: Secondary analysis of data, utilising Bayes' theorem, from meta-analyses and randomised trials.
RESULTS: In patients with a histological diagnosis of mild dysplasia who show no abnormalities on NBI, the post-test probability of malignancy is estimated to be 2.3%, compared to 10.3% with conventional white light imaging (WLI). For severe dysplasia, similar post-test probabilities after NBI and WLI are estimated to be 8.0% and 29.7%, respectively. Post-test probabilities in this setting indicate the chance of missing malignancy following a negative NBI or WLI in patients who undergo no further intervention. This study also provides a nomogram designed for use in this setting.
CONCLUSIONS: This study identifies the evidence base for use of NBI in the follow-up for laryngeal dysplasia.