Endoscopy 2010; 42(8): 613-619
DOI: 10.1055/s-0030-1255514
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers

C.  T.  Lee1 , C.  Y.  Chang1 , Y.  C.  Lee2 , C.  M.  Tai1 , W.  L.  Wang1 , P.  H.  Tseng2 , J.  C.  Hwang3 , T.  Z.  Hwang4 , C.  C.  Wang4 , J.  T.  Lin1 , 2
  • 1Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
  • 2Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  • 3Department of Pathology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
  • 4Department of Otolaryngology – Head and Neck Surgery, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
Further Information

Publication History

submitted 1 September 2009

accepted after revision 21 April 2010

Publication Date:
28 July 2010 (online)

Background and study aim: Although narrow-band imaging (NBI) in endoscopy can improve detection of early-stage esophageal malignancies in patients with head and neck cancers, false-positive results may be obtained in areas with nonspecific inflammatory changes. This study evaluated the feasibility of primary screening with NBI and magnification for the presence of esophageal malignancies in these cancer patients.

Patients and methods: Sixty-nine patients with documented head and neck cancers were enrolled from April 2008 to January 2009. All patients underwent a meticulous endoscopic examination of the esophagus using a conventional white-light system followed by re-examination using the NBI system and final confirmation with NBI plus magnification.

Results: Twenty-one patients (30.4 %) were confirmed to have esophageal neoplasia. Among these 21, 16 (76.2 %) had synchronous lesions, 9 (42.9 %) were asymptomatic, and 10 (47.6 %) had early-stage neoplasia. The incidence of multiple esophageal neoplasia was 57.1 %. NBI was more effective than conventional endoscopy in detecting neoplastic lesions (35 lesions in 21 patients vs. 22 lesions in 18 patients) and was particularly effective in patients with dysplasia (13 lesions in 9 patients vs. 3 lesions in 3 patients). The sensitivity and accuracy of detection were 62.9 % and 64.4 % for conventional endoscopy, 100 % and 86.7 % for NBI alone, and 100 % and 95.6 % for NBI with high magnification, respectively.

Conclusions: Compared with current approaches, NBI followed by high magnification significantly increases the accuracy of detection of esophageal neoplasia in patients with head and neck cancers. The result warrants conducting prospective randomized controlled study to confirm its efficacy.

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J.-T. LinMD, PhD 

Department of Internal Medicine
E-Da Hospital/I-Shou University

1, E-Da Road
Jiau-shu Tsuen
Yan-chau Shiang
Kaohsiung
Taiwan

Fax: +886-7-6155352

Email: jawtown@ntu.edu.tw