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 - 24/08/11
Reprint requests: Masayuki Kato, MD, Department of Endoscopy, The Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minato-ku, Tokyo 105-8461, JapanRésumé |
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.
Le texte complet de cet article est disponible en PDF.Abbreviations : ESD, ME-NBI, NBI, WLE
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact Dr Kato at masa-kato@jikei.ac.jp. |
Vol 72 - N° 3
P. 523-529 - septembre 2010 Retour au numéro
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