The Effectiveness of White Light Endoscopy Combined With Narrow Band Imaging Technique Using Ni Classification in Detecting Early Laryngeal Carcinoma in 114 Patients: Our Clinical Experience.

INTRODUCTION: By displaying tumor-specific neoangiogenesis, narrow band imaging (NBI), a novel imaging approach, enhances the diagnosis of head and neck cancers and makes it more accurate OBJECTIVE: To determine the effect of NBI in combination with white light endoscopy (WLE) for diagnosis of preneoplastic or neoplastic laryngeal cancers according to Ni classification and to conclude if higher Ni classification and tumor stage are related. METHODS: We enrolled 114 patients with various laryngeal cancer between December 2018 and June 2021. Patients were examined with WLE and NBI. Squamous cell carcinoma (SCC) accounted for 46 cases, benign lesions 30 cases, and nondysplastic, low-grade, and severe dysplasias for 38 cases. Based on characteristics of the intraepithelial papillary capillary loop (IPCL), endoscopic NBI results were divided into five categories (I, II, III, IV, and V). Type I-IV are regarded to be benign, while type V is considered to be cancerous. An incisional biopsy was conducted to assess histopathology, and the histopathology was compared to the NBI results. We assessed the negative predictive value (NPV), positive predictive value (PPV), specificity, and sensitivity for WLE alone and WLE combined with NBI. Analyses were conducted using SPSS software version 26. RESULTS: The WLE combined with NBI showed excellent sensitivity (96%) compared to WLE (86.4%). Specificity was higher in the WLE combined with NBI (96.4%) than WLE alone (91.7%). WLE combined with NBI saw a NPV of 89% as compared with WLE with 88%. WLE and WLE in combination with NBI, recorded a PPV of 90% and 98%, respectively. CONCLUSION: The accuracy of detecting laryngeal cancer increases when WLE and NBI are combined. Combined NBI with WLE remains highly sensitive to early glottis cancer. Accuracy of preoperative NBI was high. In the diagnosis of laryngeal cancer, a higher Ni classification closely correlates with the late stages of the glottis tumor.