{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T14:12:24Z","timestamp":1782828744806,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,6,10]],"date-time":"2017-06-10T00:00:00Z","timestamp":1497052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non\u2010neoplasia. We aimed to evaluate the ability of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, Embase, Cochrane, and Scopus databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis statement. We systematically searched for publications from 2011 until 2016. All retrieved studies were reviewed and qualitatively assessed. The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combined sensitivity of five studies (n = 687) with Ni type IV\u2010V defined as test\u2010positive was 0.89 (95% confidence interval [CI]: 0.76\u20100.95), and specificity was 0.82 (95% CI: 0.72\u20100.89). The equivalent combined sensitivity of four studies (n = 624) with Ni type V defined as test\u2010positive was 0.82 (95% CI: 0.75\u20100.87), and specificity was 0.93 (95% CI: 0.82\u20100.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The diagnostic accuracy of the Ni classification in predicting neoplasia was high, without significant difference between the two analyzed cutoff values. Implementation of the proposed ELS classification of vascular changes seems reasonable from a clinical perspective, with comparable accuracy. Attention must be drawn to the accompanying risk of exposing patients to unnecessary surgery. <jats:italic>Laryngoscope<\/jats:italic>, 128:168\u2013176, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26721","type":"journal-article","created":{"date-parts":[[2017,6,10]],"date-time":"2017-06-10T06:02:48Z","timestamp":1497074568000},"page":"168-176","source":"Crossref","is-referenced-by-count":33,"title":["Can the Ni classification of vessels predict neoplasia? A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-612X","authenticated-orcid":false,"given":"Camilla S.","family":"Mehlum","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Kirstine","family":"Dyrvig","sequence":"additional","affiliation":[{"name":"Department of Surgery Odense University Hospital Svendborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aagot Moeller","family":"Groentved","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kjaergaard","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Godballe","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3851-y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25124"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12430"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/285486"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26263"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000527"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-016-4244-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2016.07.004"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32835908ac"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-011-2428-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/coa.12728","article-title":"Narrow band imaging as screening test for early detection of laryngeal cancer: a prospective study","volume":"42","author":"Vito A","year":"2017","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1121-6"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414556082"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-003-0584-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21964"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110002033"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2010.01.007"},{"key":"e_1_2_7_20_1","first-page":"768","article-title":"Endoscopic diagnosis of tissue atypism (EA) in the pharyngeal and esophageal squamous epithelium; IPCL pattern classification and ECA classification [in Japanese]","volume":"60","author":"Inoue H","year":"2007","journal-title":"Kyobu Geka"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23582"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24300"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/175398"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23838"},{"key":"e_1_2_7_25_1","first-page":"A4399","article-title":"Aggressive elimination of precancerous lesions of the vocal cords to avoid risk of cancer","volume":"59","author":"Rohde M","year":"2012","journal-title":"Dan Med J"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115000833"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_7_28_1","unstructured":"HigginsJPT GreenS(editors).Cochrane Handbook for Systematic Reviews of Interventions. 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