2014年1月
An efficient diagnostic strategy for small, depressed early gastric cancer with magnifying narrow-band imaging: a post-hoc analysis of a prospective randomized controlled trial
GASTROINTESTINAL ENDOSCOPY
- 巻
- 79
- 号
- 1
- 開始ページ
- 55
- 終了ページ
- 63
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1016/j.gie.2013.07.008
- 出版者・発行元
- MOSBY-ELSEVIER
Background: We previously reported that magnifying narrow-band imaging (M-NBI) is a high-performance diagnostic tool for small, depressed gastric cancer. However, an efficient diagnostic strategy using endoscopic findings has not been fully elucidated.
Objective: To identify the endoscopic findings that contribute to accurate diagnosis of small, depressed gastric cancer and to propose the ideal diagnostic approach to such lesions.
Design: Post-hoc analysis of a prospective, randomized, controlled trial.
Setting: Nine hospitals.
Patients: Three hundred fifty-three patients with small, depressed gastric lesions.
Interventions: In the M-NBI group (n = 177), cancer diagnosis was made with diagnostic criteria including a demarcation line (DL) and an irregular microvascular pattern (IMVP). In the conventional white-light imaging (C-WLI) group (n = 176), diagnostic criteria were both an irregular margin and a spiny depressed area. In the C-WLI group, M-NBI was performed after C-WLI diagnosis.
Main Outcome Measurements: The diagnostic performance of each criterion in M-NBI alone, C-WLI, and M-NBI after C-WLI was investigated.
Results: M-NBI after C-WLI ultimately showed the best diagnostic performance in each diagnostic criterion. In M-NBI after C-WLI, evaluation of DL is technically easier than that of IMVP, and DL alone had a high sensitivity (95%) and negative predictive value (99%). The IMVP in M-NBI after C-WLI had a high sensitivity and specificity (95% and 96%, respectively) for diagnosis of cancer.
Limitations: Lesions were limited to the small, depressed type.
Conclusions: For a diagnosis using M-NBI after C-WLI, identification of DL is the first step, and subsequent inspection of IMVP diagnosed by DL is an efficient strategy.
Objective: To identify the endoscopic findings that contribute to accurate diagnosis of small, depressed gastric cancer and to propose the ideal diagnostic approach to such lesions.
Design: Post-hoc analysis of a prospective, randomized, controlled trial.
Setting: Nine hospitals.
Patients: Three hundred fifty-three patients with small, depressed gastric lesions.
Interventions: In the M-NBI group (n = 177), cancer diagnosis was made with diagnostic criteria including a demarcation line (DL) and an irregular microvascular pattern (IMVP). In the conventional white-light imaging (C-WLI) group (n = 176), diagnostic criteria were both an irregular margin and a spiny depressed area. In the C-WLI group, M-NBI was performed after C-WLI diagnosis.
Main Outcome Measurements: The diagnostic performance of each criterion in M-NBI alone, C-WLI, and M-NBI after C-WLI was investigated.
Results: M-NBI after C-WLI ultimately showed the best diagnostic performance in each diagnostic criterion. In M-NBI after C-WLI, evaluation of DL is technically easier than that of IMVP, and DL alone had a high sensitivity (95%) and negative predictive value (99%). The IMVP in M-NBI after C-WLI had a high sensitivity and specificity (95% and 96%, respectively) for diagnosis of cancer.
Limitations: Lesions were limited to the small, depressed type.
Conclusions: For a diagnosis using M-NBI after C-WLI, identification of DL is the first step, and subsequent inspection of IMVP diagnosed by DL is an efficient strategy.
- リンク情報
- ID情報
-
- DOI : 10.1016/j.gie.2013.07.008
- ISSN : 0016-5107
- eISSN : 1097-6779
- PubMed ID : 23932092
- Web of Science ID : WOS:000328736700011