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Review
. 2023 Mar 29;8(2):508-517.
doi: 10.1002/lio2.1049. eCollection 2023 Apr.

Accuracy of narrow-band imaging for diagnosing malignant transformation of vocal cord leukoplakia: A systematic review and meta-analysis

Jingyu Chen  1   2 , Zhuojun Li  1   2 , Ting Wu  2 , Xiumei Chen  2   3
Affiliations
Review

Accuracy of narrow-band imaging for diagnosing malignant transformation of vocal cord leukoplakia: A systematic review and meta-analysis

Jingyu Chen et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: To explore whether narrow-band imaging (NBI) endoscopy is accurate in the diagnosis of malignant transformation of vocal cord leukoplakia.

Methods: The PubMed, Embase, Cochrane Library and Web of Science databases were searched to collect data on studies reporting the use of NBI endoscopy as a diagnostic test for diagnosing vocal cord leukoplakia from January 2015 to December 2021. Study design, analysis method, and extraction results were performed according to the PRISMA guidelines. The sensitivity, specificity, pooled positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) were used to summarize the performance metrics of the meta-analysis. Risk of bias data and the quality of the included studies was evaluated according to the Quality Assessment of Diagnostic Accuracy Studies-2 tool (QUADAS-2).

Results: Nine studies were finally included in the analysis. The results of the meta-analysis showed that the pooled sensitivity and specificity of NBI endoscopy for diagnosing leukoplakia lesions were 0.76 (95% CI: 0.72-0.8) and 0.93 (95% CI: 0.91-0.95), respectively. The PLR and NLR were 10.09 (95% CI: 6.53-15.59) and 0.22 (95% CI: 0.13-0.38), respectively. The comprehensive diagnostic odds ratio (DOR) was 54.96 (95% CI: 24.32-124.17), and the area under the curve was 0.9584. The eight articles had a low risk of bias risk and one article was unclear.

Conclusion: NBI likely has good accuracy for diagnosing malignant transformation of vocal cord leukoplakia. However, multicenter studies and large samples are still needed.

Keywords: malignant transformation; meta‐analysis; narrow‐band imaging; vocal cord leukoplakia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Literature search flow diagram.
FIGURE 2
FIGURE 2
Forest plot showing pooled sensitivity and specificity of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia. I 2 > 50% was considered significant for heterogeneity. p < .10, indicating heterogeneity among studies.
FIGURE 3
FIGURE 3
Forest plot showing the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DLR) of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia. I 2 > 50% was considered significant for heterogeneity. p < .10, indicating heterogeneity among studies.
FIGURE 4
FIGURE 4
Summary receiver operating characteristic curve (SROC) showing the diagnostic performance of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia. AUC, area under the curve.
FIGURE 5
FIGURE 5
Subgroup analysis. Forest plot showing pooled sensitivity and specificity of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia, excluding articles whose mean age was less than 60 years and whose age was difficult to determine.
FIGURE 6
FIGURE 6
Forest plot showing the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DLR) of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia, excluding articles whose mean age was less than 60 years and whose age was difficult to determine.
FIGURE 7
FIGURE 7
Summary receiver operating characteristic curve (SROC) showing the diagnostic performance of narrow‐band imaging for diagnosing malignant change of vocal cord leukoplakia, excluding articles whose mean age was less than 60 years and whose age was difficult to determine.
FIGURE 8
FIGURE 8
Deeks' funnel plot for publication bias. p > .05 indicating that there is no publication bias. ESS, effective sample size.
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