Value of Magnifying Endoscopy With Narrow-Band Imaging and Confocal Laser Endomicroscopy in Detecting Gastric Cancerous Lesions

• Published in: Medicine (Baltimore) 2015-11, Vol.94 (44), p.e1930-e1930
• Main Authors: Gong, Shuai, Xue, Han-Bing, Ge, Zhi-Zheng, Dai, Jun, Li, Xiao-Bo, Zhao, Yun-Jia, Zhang, Yao, Gao, Yun-Jie, Song, Yan
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnosis; Adult; Aged; Biopsy; Diagnosis, Differential; Diagnostic Accuracy Study; Early Detection of Cancer; Female; Follow-Up Studies; Gastroscopy - methods; Humans; Male; Microscopy, Confocal - methods; Middle Aged; Narrow Band Imaging - methods; Reproducibility of Results; Retrospective Studies; Stomach Neoplasms - diagnosis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000001930

Although the respective potentials of magnifying endoscopy with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE) in predicting gastric cancer has been well documented, there is a lack of studies in comparing the value and diagnostic strategy of these 2 modalities. Our primary aim is to investigate whether CLE is superior to ME-NBI for differentiation between gastric cancerous and noncancerous lesions. A secondary aim is to propose an applicable clinical strategy.We conducted a diagnostic accuracy study involving patients with suspected gastric superficial cancerous lesions. White light endoscopy, ME-NBI, and CLE were performed diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value between ME-NBI and CLE were assessed, as well as agreements between ME-NBI/CLE and histopathology.This study involved 86 gastric lesions in 82 consecutive patients who underwent white light endoscopy, ME-NBI, and CLE before biopsy. The accuracy, sensitivity, and specificity for ME-NBI were 93.75%, 91.67%, and 95.45%, compared with 91.86%, 90%, and 93.48%, respectively, for CLE, for discrimination cancerous/noncancerous lesion (all P > 0.05). For undifferentiated/differentiated adenocarcinoma, CLE had a numerically but not statistically significantly higher accuracy than ME-NBI (81.25% vs 73.33%, P = 0.46). Agreements between ME-NBI/CLE and histopathology were near perfect (ME-NBI, κ = 0.87; CLE, κ = 0.84).CLE is not superior to ME-NBI for discriminating gastric cancerous from noncancerous lesions. Endoscopist could make an optimal choice according to the specific indication and advantages of ME-NBI and CLE in daily practices.