A randomized crossover study comparing light-induced fluorescence endoscopy with standard videoendoscopy for the detection of early neoplasia in Barrett's esophagus - 18/08/11
Reprint requests: Jacques Bergman, MD, Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.Amsterdam, The Netherlands
Abstract |
Background |
Light-induced fluorescence endoscopy (LIFE) may improve the detection of high-grade dysplasia (HGD) and early stage cancer (EC) in Barrett's esophagus (BE). The aim of this study was to compare LIFE with standard endoscopy (SE) in a randomized crossover study.
Methods |
Fifty patients with BE underwent SE and LIFE in a randomized sequence (4 to 6-week interval between procedures). The two procedures were performed by two different endoscopists who were blinded to the findings of the other examination. Targeted biopsy specimens were taken from detected lesions, followed by random biopsy specimens with a 2-cm interval, 4-quadrant protocol. Biopsy specimens were routinely evaluated and subsequently reviewed by a single, blinded expert GI pathologist.
Results |
Targeted biopsy specimens had a sensitivity for the diagnosis of HGD/EC of 62% (8/13) for both techniques. The overall sensitivity (all biopsy specimens) was 85% for SE and 69% for LIFE (p=0.69). All targeted biopsy specimens had a positive predictive value (PPV) for HGD/EC of 41% for SE and 28% for LIFE (p=0.40); autofluorescence-targeted biopsy specimens had a PPV of 13%. False-positive lesions had a significantly higher rate of acute inflammation than random biopsy specimens.
Conclusions |
In this study, LIFE did not improve the detection of HGD or EC in patients with BE compared with SE.
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| A preliminary analysis of this study was presented at the annual meeting of the American Gastroenterology Association, May 17-22, 2003, Orlando, Florida (Gastroenterology 2003;124[Suppl 1]:A-49). This study was supported by a grant from the Dutch Digestive Disease Foundation (Maag Darm Lever Stichting). |
Vol 61 - N° 6
P. 671-678 - mai 2005 Retour au numéro
Article précédent
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- George Triadafilopoulos
- Endoscopic video autofluorescence imaging may improve the detection of early neoplasia in patients with Barrett's esophagus
- Mohammed A. Kara, Femke P. Peters, Fiebo J.W. ten Kate, Sander J. van Deventer, Paul Fockens, Jacques J.G.H.M. Bergman
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