Blue laser imaging-bright improves the real-time detection rate of early gastric cancer: a randomized controlled study
Blue laser imaging-bright improves the real-time detection rate of early gastric cancer: a randomized controlled study
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DOI：
10.1016/j.gie.2018.08.049
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发表时间：
2019-01-01
影响因子：
7.7
通讯作者：
Itoh, Yoshito
中科院分区：
文献类型：
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作者：
Dohi, Osamu;Yagi, Nobuaki;Itoh, Yoshito
背景和目标：蓝色激光成像明亮（BLI-bright）已被证明是比白光成像（WLI）更有用的早期胃癌（EGC）检测工具。然而，BLI-bright 在 EGC 检测中的诊断性能尚未得到研究。我们的目的是比较 WLI 与 BLI-bright 对于 EGC 的实时检出率。方法：这是在 2 个日本学术中心进行的一项前瞻性、随机、对照研究。我们调查了 629 名因萎缩性胃炎伴肠上皮化生而接受内镜随访或内镜下 EGC 切除术后监测的患者。患者被随机分配接受主要 WLI 后接受 BLI-bright 或主要 BLI-bright 后接受 WLI。比较原发性WLI和原发性BLI-bright的EGC实时检出率。结果：每组各298例患者。初级 BLI-bright 的 EGC 实时检出率显着高于初级 WLI（93.1% vs 50.0%；P = .001）。对于有内镜下 EGC 切除史、根除治疗后胃内无幽门螺杆菌感染、开放型萎缩性边界病变、胃下三分之一病变、凹陷型病变、测量小病变的患者，原发性 BLI-bright 检测 EGC 的能力显着增强
Background and Aims: Blue laser imaging-bright (BLI-bright) has shown promise as a more useful tool for detection of early gastric cancer (EGC) than white-light imaging (WLI). However, the diagnostic performance of BLI-bright in the detection of EGC has not been investigated. We aimed to compare real-time detection rates of WLI with that of BLI-bright for EGC.Methods: This was a prospective, randomized, controlled study in 2 Japanese academic centers. We investigated 629 patients undergoing follow-up endoscopy for atrophic gastritis with intestinal metaplasia or surveillance after endoscopic resection of EGC. Patients were randomly assigned to receive primary WLI followed by BLI-bright or primary BLI-bright followed by WLI. The real-time detection rates of EGC were compared between primary WLI and primary BLI-bright.Results: There were 298 patients in each group. The real-time detection rate of EGC with primary BLI-bright was significantly greater than that with primary WLI (93.1% vs 50.0%; P = .001). Primary BLI-bright had a significantly greater ability to detect EGCs in patients with a history of endoscopic resection for EGC, no Helicobacter pylori infection in the stomach after eradication therapy, lesions with an open-type atrophic border, lesions in the lower third of the stomach, depressed-type lesions, small lesions measuring