Chromoendoscopy with indigo carmine dye added to acetic acid in the diagnosis of gastric neoplasia: a prospective comparative study
Chromoendoscopy with indigo carmine dye added to acetic acid in the diagnosis of gastric neoplasia: a prospective comparative study
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DOI：
10.1016/j.gie.2008.03.1065
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发表时间：
2008-10-01
影响因子：
7.7
通讯作者：
Yokosuka, Osamu
中科院分区：
文献类型：
--
作者：
Sakai, Yuzo;Eto, Reiko;Yokosuka, Osamu
背景资料：常规内镜和靛蓝胭脂染色内镜通常用于识别足够的肿瘤阴性侧切缘，以便成功内镜切除胃肿瘤。然而，靛蓝胭脂红染料加入醋酸的色素内镜检查尚未用于此目的。目的：我们的任务是比较靛蓝胭脂红染料加入醋酸的色素内镜检查与传统内镜检查和靛蓝胭脂红染料或醋酸单独的色素内镜检查的诊断性能。设计：前瞻性研究。设置：社会保险船桥中央医院。患者：47名连续患者方法：对2006年4月至2007年7月行内镜黏膜下剥离术（ESD）的53例早期胃癌和胃腺瘤患者进行研究。干预措施：所有病变在ESD前均行内镜检查，并对切除标本进行组织病理学分析。两名内窥镜医生独立评价了每幅图像在识别肿瘤边界方面的诊断性能，并参考了切除标本的肉眼和组织病理学结果。我们还进行了一项子研究，以评估观察者间的variability.Results：有良好的观察者之间的协议，在这项研究中的2内镜（Kappa指数= 0.764）。染色内镜中靛蓝胭脂红染料加入醋酸的诊断性能显着高于任何其他models.Conclusions：染色内镜中靛蓝胭脂红染料加入醋酸的诊断性能优于传统内镜和染色内镜，仅使用靛蓝胭脂红染料或醋酸。此方法对胃肿瘤的适用性值得进一步研究。
Background: Conventional endoscopy and chromoendoscopy with indigo carmine dye are usually performed for recognizing adequate tumor-negative lateral margins for succesful endoscopic resection of gastric neoplasia. However, chromoendoscopy with indigo carmine dye added to acetic acid has not been used for this purpose.Objective: Our pirpose was to compare the diagnostic performance of chromoendoscopy with indigo carmine dye added to acetic acid with that of conventional endoscopy and chromoendoscopy with indigo carmine dye or acetic acid alone.Deisgn: Prospective study.Setting: Social Insurance Funabashi Central Hospital.Patients: Forty-seven consecutive patients (53 lesions) with early gastric cancer and gastric adenomas who underwent endoscopic submucosal dissection (ESD) from April 2006 to July 2007 were studied.Interventions: All the lesions were examined by the endoscopic modalities before ESD, and the resected specimens were analyzed histopathologically.Main Outcomes Measurement: Two endoscopists independently evaluated the diagnostic performance of each image in terms of recognition of tumor borders with reference to macroscopic and histopathologic findings of resected specimens. We also conducted a substudy to assess interobserver variability.Results: There was good interobserver agreement between the 2 endoscopists in this study (kappa index = 0.764). The diagnostic performance of chromoendoscopy with indico carmine dye added to acetic acid was significantly greater than that of any of the other modalities (vs each: P < .005).Conclusions: The diagnostic performance of chromoendoscopy with indigo carmine dye added to acetic acid was better compared with conventional endoscopy and chromoendoscopy by using only indigo carmine dye or acetic acid. The applicability of this method for gastric neoplasia merits further investigation.