Abstract
INTRODUCTION: Laryngeal carcinoma is a type of cancer that occurs in the laryngeal tissue with a high mortality rate. Fiber optic laryngoscopy examination with i-scan is a non-invasive technology used to visualize changes in the structure of the mucosa and blood vessels, aiding in better identification of malignancies. Despite its promising potential, the routine use of i-scan technology in examinations is not yet established in Indonesia, especially West Java. OBJECTIVE: To compare endoscopic findings using i-scan with histopathological results in patients with laryngeal carcinoma. METHODS: This study is an analytical prospective observational research with a cross-sectional design, followed by a concordance test analysis using accuracy tests and the kappa index. The data collected include information from all laryngeal tumor patients at the ORLHNS outpatient clinic at Dr. Hasan Sadikin General Hospital from July to December 2023. RESULTS: This prospective observational study evaluated i-scan endoscopy's diagnostic accuracy versus histopathology in 29 laryngeal carcinoma patients, demonstrating 96% sensitivity (95% CI [80.4-99.3%]) and 100% specificity (95% CI [39.8-100%]) with substantial histopathological agreement (κ = 0.86, 95% CI [0.61-1.00]). The technology outperformed white light endoscopy (κ = 0.608) in detecting malignancies, correctly identifying vascular patterns in 24/25 malignant cases (eight poorly differentiated, six moderately differentiated, five well-differentiated squamous cell carcinomas) and all four benign lesions. One false-negative involved a well-differentiated carcinoma, potentially due to obscuring edema or tumor positioning. These findings underscore i-scan's utility for precise malignancy detection and biopsy guidance in laryngeal carcinoma evaluation. CONCLUSION: Our findings demonstrate concordance between i-scan endoscopic examination and histopathological results in laryngeal carcinoma evaluation. While this study provides preliminary evidence supporting the potential utility of i-scan technology for early lesion identification and biopsy targeting, further validation through larger-scale multicenter studies is warranted to confirm its clinical applicability.