Usefulness of non-magnifying narrow-band imaging in screening of early esophageal squamous cell carcinoma: a prospective comparative study using propensity score matching.
Usefulness of non-magnifying narrow-band imaging in screening of early esophageal squamous cell carcinoma: a prospective comparative study using propensity score matching.
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DOI：
10.1038/ajg.2014.94
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发表时间：
2014-06
影响因子：
9.8
通讯作者：
Arakawa, Tetsuo
中科院分区：
文献类型：
--
作者：
Nagami, Yasuaki;Tominaga, Kazunari;Machida, Hirohisa;Nakatani, Masami;Kameda, Natsuhiko;Sugimori, Satoshi;Okazaki, Hirotoshi;Tanigawa, Tetsuya;Yamagami, Hirokazu;Kubo, Naoshi;Shiba, Masatsugu;Watanabe, Kenji;Watanabe, Toshio;Iguchi, Hiroyoshi;Fujiwara, Yasuhiro;Ohira, Masaichi;Hirakawa, Kosei;Arakawa, Tetsuo
非放大内镜窄带成像（NBI; NM-NBI）在早期食管鳞状细胞癌（SCC）和高度上皮内瘤变（HGIN）筛查中的作用尚不清楚。在此，我们的目的是比较NM-NBI和染色内镜与碘染色（CE-碘）的诊断性能，并评估NM-NBI在检测早期食管SCC的有用性。我们前瞻性地纳入了202例具有食管SCC高危因素的连续患者（男性/女性=180/22;中位年龄67岁）。所有患者均接受NM-NBI和CE-碘内镜检查，以筛查早期食管SCC或HGIN。我们按顺序进行检查，并通过基于每个病变的分析计算准确性，灵敏度和特异性。进行倾向评分匹配分析以减少选择偏倚的影响，并在匹配后根据NM-NBI和CE-碘比较各自的结局。NM-NBI的准确性、敏感性和特异性分别为77.0%、88.3%和75.2%，CE-碘未染色区域的准确性、敏感性和特异性分别为68.0%、94.2%和64.0%。NM-NBI的准确性和特异性均上级CE-碘（P=0.03和P=0.01）。然而，NM-NBI和CE-碘之间的灵敏度没有显著差异（P=0.67）。配型前NM-NBI的准确性和特异性均上级配型后CE-碘（P=0.04和P=0.03）。NM-NBI对食管鳞癌的诊断是有效和可靠的，可以作为早期食管鳞癌的一种有前途的筛查策略。
The usefulness of non-magnifying endoscopy with narrow-band imaging (NBI; NM-NBI) in the screening of early esophageal squamous cell carcinoma (SCC) and high-grade intraepithelial neoplasia (HGIN) remains unclear. Here, we aimed to compare NM-NBI and chromoendoscopy with iodine staining (CE-Iodine) in terms of the diagnostic performance, and to evaluate the usefulness of NM-NBI in detecting early esophageal SCC. We prospectively enrolled 202 consecutive patients (male/female=180/22; median age, 67 years) with high-risk factors for esophageal SCC. All patients received endoscopic examination with NM-NBI and CE-Iodine to screen for early esophageal SCC or HGIN. We conducted the examinations sequentially, and calculated the accuracy, sensitivity, and specificity through a per-lesion-based analysis. A propensity score matching analysis was performed to reduce the effects of selection bias, and we compared the respective outcomes according to NM-NBI and CE-Iodine after matching. The accuracy, sensitivity, and specificity of NM-NBI were 77.0, 88.3, and 75.2%, respectively, and those for unstained areas by CE-Iodine were 68.0, 94.2, and 64.0, respectively. The accuracy and specificity of NM-NBI were superior to those of CE-Iodine (P=0.03 and P=0.01, respectively). However, the sensitivity did not significantly differ between NM-NBI and CE-Iodine (P=0.67). The accuracy and specificity of NM-NBI before matching were superior to those of CE-Iodine after matching (P=0.04 and P=0.03). NM-NBI was useful and reliable for the diagnosis of esophageal SCC and can be a promising screening strategy for early esophageal SCC.
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影响因子：
1.9
作者：
ROSENBAUM, PR;RUBIN, DB
通讯作者：
RUBIN, DB
影响因子：
4.9
作者：
METZ, CE
通讯作者：
METZ, CE
影响因子：
24.5
作者：
Schlemper, RJ;Riddell, RH;Yamabe, H
通讯作者：
Yamabe, H
影响因子：
3.7
作者：
ROSENBAUM, PR;RUBIN, DB
通讯作者：
RUBIN, DB
影响因子：
7.7
作者：
Lee, Yi-Chia;Wang, Cheng-Ping;Wang, Hsiu-Po
通讯作者：
Wang, Hsiu-Po