Comparative Analysis Of Vascular Morphology Between Narrow-band Imaging And White-light Imaging Endoscopy In The Diagnosis Of Nasopharyngeal Carcinoma

OBJECTIVE: To further investigate the value of vascular morphology in the diagnosis of nasopharyngeal carcinoma by analyzing the different lesions and different vascular morphology of the nasopharynx under NBI endoscopy and white light endoscopy.METHODS: Patients with suspected nasopharyngeal masses from the Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,from February 2018 to March 2019,were included in the study.A total of 124 cases were collected in this study,including 80 males and 44 females,aged between 20 and 75 years,with a median age of 48 years.Patients were examined in white light mode and NBI mode and collected images and videos for biopsy at suspicious sites.According to the results of pathological tissue,the white light pattern in nasopharyngoscopy and the morphological characteristics of the nasopharynx in narrow-band mode were compared.And analyze the white light mode,narrow band mode and the combination of the two modes to diagnose the efficacy of nasopharyngeal carcinoma;The clinical staging data of the above patients were collected to explore the characteristics of surface vascular morphology of nasopharyngeal carcinoma and its association with clinical stage of tumor.Statistical software was used for analysis.RESULTS:The pathological results showed that among the 124 patients,88 were nasopharyngeal malignant tumors,including 86 cases of undifferentiated non-keratinized carcinoma,1 case of poorly differentiated non-keratinized carcinoma,and 1 case of differentiated keratocarcinoma.There were 36 cases of non-malignant lesions,including 33 cases of chronic mucosal inflammation,1 case of cyst,2 cases of tuberculosis,and 1 case of dysplasia.Except for follicular-like structures and spotted blood vessels(P<0.05),white light and NBI had the same ability to distinguish other vascular morphology(including non-specific blood vessels,fine dendritic vessels,large blood vessels,and sickle vessels)(P>0.05).The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of nasopharyngeal carcinoma were 94.3%,52.8%,83.0%,79.2%,and 73.5%,respectively;the NBI mode was 60.2% and 86.1%,respectively.91.4%,47.0%,73.2%;white light + NBI mode were 96.6%,41.7%,80.2%,83.3%,and 69.1%,respectively.The sensitivity of white light mode to diagnosis of nasopharyngeal carcinoma was higher(94.3%)than that of NBI(60.2%),and the accuracy of white light mode for diagnosis of nasopharyngeal carcinoma was 73.5%(NBI mode was 73.1%,white light + NBI mode was 69.1).%),the difference was statistically significant(P<0.05).In the diagnosis of nasopharyngeal carcinoma,specific vascular morphological types(spotted blood vessels,dense thin dendritic vessels,spur-like vessels,and sacral vessels)were not statistically different between the early and late stages of nasopharyngeal carcinoma(X2 values).0.437,1.143,0.431,1.975,respectively;P values are >0.05)CONCLUSION: NBI mode is superior to white light mode in the morphology of follicular-like structures and spotted blood vessels.The NBI mode is in the form of other blood vessels(no specific blood vessels,dense thin dendritic vessels,coarse branches).The ability to distinguish between dry blood vessels and sickle blood vessels is comparable to that of white light;White light pattern examination of lesion morphological changes is more sensitive to nasopharyngeal carcinoma than surface vascular morphology assessment in NBI mode;For nasopharyngeal carcinoma,the NBI model does not have an advantage over the white light mode.NBI endoscopic diagnosis of nasopharyngeal carcinoma alone can cause missed diagnosis of a certain number of patients;Nasopharyngeal vascular morphological types cannot predict local tumor staging in patients with nasopharyngeal carcinoma.