Use of Narrow-Band Imaging in Detection of Nasopharyngeal Carcinoma

Abstract

Objective: Compare narrow-band images of nasopharyngeal carcinoma (NPC) with normal nasopharyngeal mucosa and adenoidal tissue.

Method: Prospective study on patients attending the Ear, Nose and Throat (ENT) clinic. Nasoendoscopic evaluation using both conventional white light (WLI) and narrow band light (NBI) were performed. Biopsies of the nasopharynx were performed for histological confirmation. Epstein-Barr virus (EBV) serology was tested in all patients.

Results: Thirty patients were recruited. Of these, 21 patients had no evidence of malignancy on both histological and serological testing. Seven patients had NPC and 1 patient had nasopharyngeal papillary adenocarcinoma. NBI features identified in normal nasopharyngeal mucosa and adenoids, are: 1) regularly arranged follicular pattern, whereby 2) “follicles” are composed of pale centers with dark peripheries. In comparison, NBI appearances of NPC are noted to show 1 or more of the following features: 1) absence of surface patterns, 2) dark brown, irregular wave-like surface patterns, and/or 3) irregular follicular patterns with dark brown centers and pale peripheries.

Conclusion: With NBI, features on the surface of nasopharyngeal mucosa, adenoidal tissue and NPC are clearly demonstrated and consistently show characteristics as described. NBI may therefore be a useful adjunct in differentiating normal mucosa and tissue from malignancy. Further studies are needed to evaluate its diagnostic accuracy.