ROLE OF NARROW BAND IMAGING SYSTEM IN EARLY DIAGNOSIS OF POTENTIALLY MALIGNANT LESIONS OF ORAL CAVITY

Abstract

Laveena P. Mehta1, Yessukrishna Prabhakar Shetty2, Sharad B. Bhalekar3, Yogesh G. Dabholkar4, Haritosh K. Velankar5

INTRODUCTION Oral squamous cell carcinomas (OSCC) are frequently preceded by or associated with leucoplakia, erythroplakia, oral submucous fibrosis or lichen planus. The standard method of revealing PML potentially malignant lesions of oral mucosa or submucosa is usually done via conventional oral examination (COE), direct visualisation and biopsy with the aid of image-enhanced endoscopy along with high-resolution imaging system. In view of the promising results of using Narrow Band Imaging as a screening aid in cancer screening, a prospective randomised study was performed to evaluate statistically the efficacy of NBIS in diagnosis of potentially malignant lesions in oral cavity using histopathology as gold standard.
METHODOLOGY 236 potentially malignant lesions in oral cavity from 195 patients underwent Broadband white light & NBI-endoscopic evaluation according to the Inoue’s classification. The histopathology results were compared with Broadband white light & Narrow Band light evaluation.
RESULTS
The sensitivity, specificity, positive predictive value, negative predictive value and clinical accuracy for the detection of oral potentially malignant disorders or worse by Narrow Band Imaging were 96 %, 83%, 96%, 83% and 93.22 % respectively. The sensitivity, specificity, positive predictive value, negative predictive value and clinical accuracy with conventional broadband white light oral examination were 72%, 63%, 88%, 36% and 70.33% respectively for the detection of oral potentially malignant disorders.
CONCLUSION NBI endoscopy has diagnostic utility as ‘Optical Biopsy’ for superficial squamous neoplasms in the oral cavity and hence can be considered as a screening tool in high risk patients.

image