The aim of this study was to investigate whether observing microvascular changes by narrow-band imaging (NBI) endoscopy in the area surrounding leukoplakia is sufficient for discriminating between benign and malignant patterns of vocal cord leukoplakia. A total of 282 patients were investigated using white-light high-definition TV laryngoscopy and NBI endoscopy from 6/2013 to 8/2015, and 63 patients with a primary case of laryngeal leukoplakia were enrolled. Patients were divided into two groups based on leukoplakia with surrounding malignant intraepithelial papillary capillary loops (group I; 26/63) and leukoplakia with a surrounding benign vascular network (group II; 37/63), both by NBI endoscopy. All 63 patients were evaluated by blinded histological examination, and results were compared with NBI optical biopsy. Carcinoma in situ or invasive squamous cell carcinoma was confirmed in 22/26 cases (84.6 %) in group I. Hyperkeratosis or low-grade dysplasia was confirmed histologically in 31/37 (83.8 %) and squamous cell carcinoma in 2/37 (5.4 %) cases in group II. Accordance of NBI endoscopy and histopathological features of vocal cord leukoplakia lesions was statistically significant (kappa index 0.77, p < 0.001), with a sensitivity of 88.0 % (95 % CI 67.8-97.5 %) and specificity of 89.5 % (95 % CI 71.2-97.1 %). NBI is convenient for improving evaluation of laryngeal leukoplakias based on optic prehistological diagnosis. The close accordance between NBI features and histological results suggests that a negative NBI endoscopy may be an indication for long-term endoscopy follow-up without histological evaluation.

Department of Craniofacial Surgery Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery Faculty of Medicine in Hradec Králové University Hospital Hradec Králové Charles University Prague Prague Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Ostrava 17 listopadu 1790 708 52 Ostrava Czech Republic

See more in PubMed

Int J Oral Maxillofac Surg. 2013 Jun;42(6):693-701 PubMed

Head Neck. 1991 Nov-Dec;13(6):488-97 PubMed

Histopathology. 2009 May;54(6):639-56 PubMed

J Laryngol Otol. 2011 Mar;125(3):288-96 PubMed

Eur Arch Otorhinolaryngol. 2009 Jul;266(7):1017-23 PubMed

Curr Opin Otolaryngol Head Neck Surg. 2012 Dec;20(6):472-6 PubMed

Z Laryngol Rhinol Otol. 1963 May;42:339-62 PubMed

Int Arch Otorhinolaryngol. 2014 Oct;18(4):352-6 PubMed

Laryngoscope. 2012 Feb;122(2):336-42 PubMed

Head Neck. 2012 Nov;34(11):1574-9 PubMed

Biomed Res Int. 2014;2014:285486 PubMed

Ann Otol Rhinol Laryngol. 2008 Jan;117(1):74-9 PubMed

Laryngoscope. 2002 Mar;112(3):488-93 PubMed

Klin Onkol. 2015;28(2):116-20 PubMed

Laryngoscope. 2015 Feb;125(2):E62-6 PubMed

Eur Arch Otorhinolaryngol. 2010 Mar;267(3):409-14 PubMed

Head Neck. 2001 Jan;23(1):42-7 PubMed

Acta Otolaryngol Suppl. 1997;527:142-4 PubMed

Eur Arch Otorhinolaryngol. 2016 May;273(5):1207-14 PubMed

Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1719-24 PubMed

Acta Otorhinolaryngol Ital. 2003 Oct;23(5):362-7 PubMed

Laryngoscope. 2012 Dec;122(12):2754-61 PubMed

Clinical significance of type IV vascularization of laryngeal lesions according to the Ni classification

Evolution of mucosal vasculature after radiotherapy of T1 vocal cord cancer: a pilot study

Narrative Review of Classification Systems Describing Laryngeal Vascularity Using Advanced Endoscopic Imaging

Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer

Diagnosis of Laryngeal Pemphigus Vulgaris Can Be Facilitated Using Advanced Endoscopic Methods

Comparison of narrow band imaging and the Storz Professional Image Enhancement System for detection of laryngeal and hypopharyngeal pathologies