Kontaktendoskopie mit Narrow Band Imaging zur Erkennung perpendikulärer Gefäßveränderungen bei benignen Läsionen, Dysplasien und Karzinomen der Stimmlippen

Schöninger, L; Voigt-Zimmermann, Susanne; Kropf, Siegfried; Arens, Christoph; Davaris, Nikolaos

doi:10.1007/s00106-021-01063-8

Cited by 1 publication

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References 28 publications

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“…However, adequate interpretation of “optical” biopsy lesions with type IV vascularization according to Ni is difficult because of the considerable variability of final histopathology results. Studies published in recent years confirm that using NBI combined with contact endoscopy to detect high-grade dysplasia and carcinoma increases diagnostic quality ( 13 , 58 ).…”

Section: Discussionmentioning

confidence: 89%

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

Staníková,

Kántor,

Fedorová

et al. 2024

Front. Oncol.

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BackgroundScattered, small, dot-like intraepithelial papillary capillary loops (IPCLs) represent type IV epithelial vascularization according to “Ni classification” and are considered to be nonmalignant. According to the European Laryngological Society classification, these loops are malignant vascular changes. This contradiction has high clinical importance; therefore, clarification of the clinical significance of type IV vascularization according to the Ni classification is needed.MethodsThe study was performed between June 2015 and December 2022. All recruited patients (n = 434) were symptomatic, with macroscopic laryngeal lesions (n = 674). Patients were investigated using the enhanced endoscopic methods of narrow band imaging (NBI) and the Storz Professional Image Enhancement System (IMAGE1 S). The microvascular patterns in the lesions were categorized according to Ni classification from 2011 and all lesions were examined histologically.ResultsA total of 674 lesions (434 patients) were investigated using flexible NBI endoscopy and IMAGE1 S endoscopy. Type IV vascularization was recognized in 293/674 (43.5%) lesions. Among these 293 lesions, 178 (60.7%) were benign (chronic laryngitis, hyperplasia, hyperkeratosis, polyps, cysts, granulomas, Reinkeho oedema and recurrent respiratory papillomatosis); 9 (3.1%) were squamous cell carcinoma; 61 (20.8%) were mildly dysplastic, 29 (9.9%) were moderately dysplastic, 14 (4.8%) were severe dysplastic and 2 (0.7%) were carcinoma in situ. The ability to recognize histologically benign lesions in group of nonmalignant vascular pattern according to Ni (vascularization type I-IV) and distinguish them from precancers and malignancies was with accuracy 75.5%, sensitivity 54.4%, specificity 94.4%, positive predictive value 89.6% and negative predictive value 69.9%.ConclusionLaryngeal lesions with type IV vascularization as defined by Ni present various histological findings, including precancerous and malignant lesions. Patients with type IV vascularization must be followed carefully and, in case of progression mucosal lesion microlaryngoscopy and excision are indicated.

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Section: Discussionmentioning

confidence: 89%