Comparison of the diagnostic value of white light endoscopic, narrow band imaging, and iodine staining individually and in combination for early esophageal cancer and precancerous lesions.

Objective: To compare the diagnostic efficacy of white light endoscopic (WLE), narrow band imaging (NBI), and iodine staining, both individually and in combination, for the detection of early esophageal cancer (EC) and precancerous lesions. Methods: A retrospective analysis was conducted on 55 patients with suspected early EC or precancerous lesions who were treated at Wuxi Second People's Hospital between January 2022 and June 2023. All patients underwent simultaneous endoscopic examination using WLI, NBI, and iodine staining. A total of 63 lesions were identified. Surgical histopathological results and/or follow-up confirmation served as the gold standard. The diagnostic performance (including accuracy, sensitivity, and negative predictive value) of each method individually and in combination was observed and compared. Results: Among the 63 suspected lesions, 5 cases of early EC and 37 cases of precancerous lesions were confirmed by histopathology or follow-up. The combined diagnostic and iodine staining approach demonstrated significantly higher accuracy and sensitivity for early EC compared to WLI or NBI alone ( Conclusion: Both endoscopic NBI and iodine staining exhibit relatively high clinical detection rates for early EC and precancerous lesions. Their combined use can further enhance the detection rate of these conditions.