INTRODUCTION: Enhanced contact endoscopy (ECE) is a non-invasive technique used for the assessment of superficial vascular changes of mucosal lesions in high magnification. The aim of our study was to evaluate the clinical efficacy of ECE in an intraoperative settlement. METHODS: Structured assessment of laryngeal mucosal lesions using enhanced endoscopy (narrow band imaging (NBI) and ECE) was performed in a prospective clinical trial. Lesions were classified according to the European Laryngological Society Classification into non-suspicious and suspicious. Evaluations of endoscopic methods (NBI and ECE) were correlated with histopathology, histopathology being the gold standard. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), area under curve, diagnostic odds ratio (DOR), Kappa, incremental yield, and Youden´s index for NBI and ECE were calculated. RESULTS: A total of 110 patients with 136 lesions were enrolled, 50 benign non-neoplastic lesions, eight squamous cell papillomas, 45 dysplasias, and 33 squamous cell invasive cancers. Compared to NBI, ECE demonstrated higher sensitivity (91.0% vs 83.1%) and accuracy (90.4% vs 86.8%). NBI achieved higher specificity (91.8% vs 89.7%). PPV and NPV for ECE were 92.2% and 88.1%, whereas for NBI 93.1% and 80.4%. ECE showed greater overall diagnostic performance, with a DOR of 88.3 vs 55.2 and Kappa index of 0.805 vs 0.736. CONCLUSIONS: ECE enhances diagnostic sensitivity and accuracy and represents a valuable addition to laryngeal cancer diagnostics.

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

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Ostrava Ostrava Czech Republic; Department of Craniofacial Surgery Faculty of Medicine University of Ostrava Ostrava Czech Republic

Faculty of Medicine in Hradec Kralove Charles University Prague Czech Republic; The Fingerland Department of Pathology University Hospital Hradec Kralove Hradec Kralove Czech Republic

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