Evaluation of Microvascular Patterns Alone Using Endocytoscopy with Narrow-Band Imaging for Diagnosing Gastric Cancer
Evaluation of Microvascular Patterns Alone Using Endocytoscopy with Narrow-Band Imaging for Diagnosing Gastric Cancer
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DOI：
10.1159/000520276
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发表时间：
2021-12-01
期刊：
影响因子：
3.2
通讯作者：
Fujisaki, Junko
中科院分区：
文献类型：
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作者：
Horiuchi, Yusuke;Hirasawa, Toshiaki;Fujisaki, Junko
简介：虽然内吞细胞镜检查 (EC) 结合窄带成像 (NBI) 可以有效诊断胃癌，但尚未验证诊断系统。我们探索了一种使用 EC 和 NBI 的胃癌特异性诊断系统。方法：由接受过（开发组：33）和没有（验证组：28）NBI 放大内窥镜专门培训的内窥镜医师评估来自癌性和非癌性区域的相同数量的图像（各 114 个图像）。评估每幅图像中的微血管和微表面图案（MS）。当模式被认为“不规则”时，病变被诊断为癌性。根据 NBI 的 EC 模式（单独的微血管模式 [MV]、单独的 MS 或两者）评估和比较组间诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值，以确定诊断性能。结果：在开发组和验证组中，仅基于 MV 的诊断具有显着更高的准确度（分别为 91.7% vs. 76.3%，p < 0.0001 和 92.5% vs. 67.5%，p < 0.0001）和敏感性（88.6% vs. 68.3%，p < 0.0001 和 89.5% vs. 38.6%，p < 0.0001）比仅基于 MS 的结果要好。在两组中，单独使用 MV 和两种模式的诊断准确性没有显着差异。讨论/结论：单独评估 MV 是一种简单而准确的胃癌诊断方法。该系统可以在临床实践中得到广泛的应用。
Introduction: Although endocytoscopy (EC) with narrow-band imaging (NBI) is effective in diagnosing gastric cancer, no diagnostic system has been validated. We explored a specific diagnostic system for gastric cancer using EC with NBI. Methods: Equal numbers of images from cancerous and noncancerous areas (114 images each) were assessed by endoscopists with (development group: 33) and without (validation group: 28) specific training in magnifying endoscopy with NBI. Microvascular and microsurface patterns (MS) in each image were evaluated. Lesions were diagnosed as cancerous when patterns were deemed "irregular." The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of a diagnosis according to patterns on EC with NBI (microvascular pattern [MV] alone, MS alone, and both) were evaluated and compared between groups to determine the diagnostic performance. Results: In the development and validation groups, diagnoses based on the MV alone had significantly higher accuracy (91.7% vs. 76.3%, p < 0.0001 and 92.5% vs. 67.5%, p < 0.0001, respectively) and sensitivity (88.6% vs. 68.3%, p < 0.0001 and 89.5% vs. 38.6%, p < 0.0001, respectively) than those based on the MS alone. In both groups, there were no significant differences in diagnostic accuracy between using the MV alone and both patterns. Discussion/Conclusion: Evaluation of the MV alone is a simple and accurate diagnostic method for gastric cancer. This system could find widespread applications in clinical practice.