Magnifying endoscopy with narrow-band imaging achieves superior accuracy in the differential diagnosis of superficial gastric lesions identified with white-light endoscopy: a prospective study
Magnifying endoscopy with narrow-band imaging achieves superior accuracy in the differential diagnosis of superficial gastric lesions identified with white-light endoscopy: a prospective study
复制标题
DOI：
10.1016/j.gie.2010.04.041
复制
发表时间：
2010-09-01
影响因子：
7.7
通讯作者：
Tajiri, Hisao
中科院分区：
文献类型：
--
作者：
Kato, Masayuki;Kaise, Mitsuru;Tajiri, Hisao
背景：传统的白光成像内窥镜检查(WLE)会导致早期胃癌的大量误诊。放大胃镜结合窄带成像(ME-NBI)对胃癌的诊断具有较高的准确性，同时结合胃黏膜细小结构消失、微血管扩张和异质性的诊断。目的：本研究的目的是评价放大胃镜结合窄带成像(ME-NBI)在与常规WLEs鉴别诊断胃浅表病变中的优势。比较研究。地点：单学术中心。患者：这项研究包括因胃癌风险高而接受WLE和ME-NBI检查的同步或异时性癌症的患者。干预：WLE诊断为癌症或非癌症且有轻微癌症嫌疑的浅表性胃病变患者前瞻性纳入研究。结果：111例患者(男性98例，女性13例，平均年龄66.3岁)共201个病灶(平均直径[+/-SD]7.0+/-4.0 mm)被评估。201个病变中有14个经病理证实为胃癌，其余为非癌病变。Me-NBI诊断ME-NBI的敏感度和特异度分别为92.9%和94.7%，明显优于WLE(分别为42.9%和61.0%；P<；0.0001)。限制：单一中心和高度选择的胃癌高危人群。结论：ME-NBI对WLE确定的浅表胃部病变的鉴别诊断具有较高的准确性。因此，ME-NBI可能会增加胃镜检查在胃癌高危人群中的诊断价值。(《胃镜》2010；72：523-9。)
Background: Conventional, white-light imaging endoscopy (WLE) results in a significant number of misdiagnoses in early gastric cancer. Magnifying endoscopy combined with narrow-band imaging (ME-NBI) is more accurate in the diagnosis of gastric cancer when the diagnostic triad of the disappearance of fine mucosal structure, microvascular dilation, and heterogeneity is used.Objective: The aim of the present study was to evaluate the superiority of ME-NBI in the differential diagnosis of superficial gastric lesions identified with conventional WLE.Design: Prospective, comparative study.Setting: Single academic center.Patients: This study involved patients who underwent WLE and ME-NBI for surveying synchronous or metachronous cancers because they had a high risk of gastric cancer.Intervention: Patients with superficial gastric lesions that were diagnosed by WLE as cancer or non-cancer with a slight suspicion of cancer were prospectively enrolled in the study. ME-NBI was used to further characterize lesions picked up with WLE.Main Outcome Measurements: Sensitivity and specificity for the diagnosis of gastric cancer, with pathology as the criterion standard.Results: A total of 201 lesions (mean diameter [+/- SD] 7.0 +/- 4.0 mm) from 111 patients (98 men, 13 women; mean age 66.3 years) were evaluated. Fourteen of the 201 lesions were pathologically proven as gastric cancer; the others were noncancerous lesions. The sensitivity and specificity for ME-NBI diagnosis with the use of the triad (92.9% and 94.7%, respectively) were significantly better than for WLE (42.9% and 61.0%, respectively; P < .0001).Limitations: Single center and a highly selected population at high risk for gastric cancer.Conclusion: ME-NBI achieved superior accuracy in the differential diagnosis of superficial gastric lesions identified with WLE. Thus, ME-NBI may increase the diagnostic value of endoscopy in a population at high risk of gastric cancer. (Gastrointest Endosc 2010;72:523-9.)