Search

Background: Nonmagnifying observation by using narrow-band imaging (NBI) is useful for detecting pharyngeal lesions. Magnifying observation by using NBI can distinguish between cancerous and noncancerous lesions and is therefore useful for the early detection of pharyngeal cancer. Objective: To evaluate the usefulness of observation of the pharynx by using NBI in the overall population undergoing upper GI endoscopy. Design: Retrospective study. Setting: Single tertiary referral center. Patients: A total of 11,050 upper GI endoscopies between January 2009 and December 2012. Interventions: Observation of the pharynx by using NBI. Main Outcome Measures: The rate of detection of pharyngeal cancer, the rates of detection according to the reason for endoscopy, and the types of cancers detected. Results: Thirty-eight cancerous lesions were detected in 29 patients (0.26%, 29/11,050). The rate of detection of pharyngeal cancer was significantly higher in patients with a history of head and neck cancer (9.7%, 3/31) or a history of esophageal cancer (3.5%, 10/282). In patients undergoing endoscopy for screening, pharyngeal discomfort, and a history of gastric cancer, the rates of detection of pharyngeal cancer were 0.11% (10/8872), 1.1% (3/265), and 0.19% (3/1600), respectively. Two patients (6.9%) were female. One had a history of esophageal cancer, and the other had pharyngeal discomfort. Limitations: Single-center, retrospective study. Conclusions: Observation of the pharynx by using NBI in patients with previous head and neck cancer or esophageal cancer or who have pharyngeal discomfort is very important. Moreover, pharyngeal cancer was certainly found in the male patients undergoing screening endoscopy, although the rate was lower. [ABSTRACT FROM AUTHOR]

Background: Nonmagnifying observation by using narrow-band imaging (NBI) is useful for detecting pharyngeal lesions. Magnifying observation by using NBI can distinguish between cancerous and noncancerous lesions and is therefore useful for the early detection of pharyngeal cancer. Objective: To evaluate the usefulness of observation of the pharynx by using NBI in the overall population undergoing upper GI endoscopy. Design: Retrospective study. Setting: Single tertiary referral center. Patients: A total of 11,050 upper GI endoscopies between January 2009 and December 2012. Interventions: Observation of the pharynx by using NBI. Main Outcome Measures: The rate of detection of pharyngeal cancer, the rates of detection according to the reason for endoscopy, and the types of cancers detected. Results: Thirty-eight cancerous lesions were detected in 29 patients (0.26%, 29/11,050). The rate of detection of pharyngeal cancer was significantly higher in patients with a history of head and neck cancer (9.7%, 3/31) or a history of esophageal cancer (3.5%, 10/282). In patients undergoing endoscopy for screening, pharyngeal discomfort, and a history of gastric cancer, the rates of detection of pharyngeal cancer were 0.11% (10/8872), 1.1% (3/265), and 0.19% (3/1600), respectively. Two patients (6.9%) were female. One had a history of esophageal cancer, and the other had pharyngeal discomfort. Limitations: Single-center, retrospective study. Conclusions: Observation of the pharynx by using NBI in patients with previous head and neck cancer or esophageal cancer or who have pharyngeal discomfort is very important. Moreover, pharyngeal cancer was certainly found in the male patients undergoing screening endoscopy, although the rate was lower. [Copyright &y& Elsevier]

An e-learning system teaching endoscopic diagnostic process for early gastric cancer using magnifying endoscopy with narrow-band imaging (M-NBI) was established, and its efficacy in improving the diagnostic performance for early gastric cancer was proven in a multicenter randomized controlled trial. The aim of this study was to clarify the difference in learning effect in each lesion characteristic. Three hundred sixty-five participants diagnosed 40 gastric lesions based on M-NBI findings using the vessel-plus-surface classification system. The diagnosis data collected from each participant were assessed in this study. The accuracy of NBI cancer diagnosis was assessed using area under the receiver operating characteristics curve (AUC/ROC) analysis. AUC/ROCs were separately calculated in each lesion characteristic (shape and size), and the data were compared between tests 1 and 3. Continuous net reclassification improvement (cNRI) analysis of all lesions revealed significant improvement in reclassification when participants underwent e-learning (cNRI, 1.17; P <.01). The integrated discrimination improvement analysis demonstrated that the e-learning system improved diagnostic ability (.19; P <.01). According to the analysis depending on the lesion's characteristics, high AUC/ROCs were demonstrated in depressed and small lesions (<10 mm;.90 and.93, respectively). The cNRI analysis showed remarkable e-learning improvement in both depressed (cNRI, 1.33; P <.01) and small lesions (cNRI, 1.46; P <.01). However, no significant e-learning improvement was observed in elevated or flat lesions. In M-NBI education for endoscopists, a good learning outcome was obtained in depressed and small lesions, but a poor learning outcome was demonstrated in elevated and flat lesions. (Clinical trial registration number: UMIN000008569.) [ABSTRACT FROM AUTHOR]