論文

筆頭著者
2019年7月

Feasibility of a simplified narrow-band imaging classification system for Barrett's esophagus for novice endoscopists.

Journal of gastroenterology
  • Hiroto Furuhashi
  • Kenichi Goda
  • Yuichi Shimizu
  • Masayuki Kato
  • Masakazu Takahashi
  • Akira Dobashi
  • Koji Hirata
  • Ayane Oba
  • Taku Shigesawa
  • Masaki Inoue
  • Hiroaki Matsui
  • Chika Kinoshita
  • Yoshitaka Ando
  • Masahiro Ikegami
  • Tadakazu Shimoda
  • Mototsugu Kato
  • 全て表示

54
7
開始ページ
587
終了ページ
596
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00535-018-01537-7

BACKGROUND: Narrow-band imaging (NBI) classifications for Barrett's esophagus have been proposed for the detection of early esophageal adenocarcinoma. We developed a simplified classification system with demonstrated high diagnostic accuracy and reproducibility among experienced endoscopists, but the feasibility of this system among novice endoscopists was unclear. METHODS: In the present study, eight novice endoscopists with no experience of magnification endoscopy were asked to review 248 images of Barrett's esophagus (72 dysplastic, 176 non-dysplastic) obtained using high-definition magnification endoscopy with NBI 6 weeks before (1st test), immediately after (2nd test), and 6 weeks after (3rd test) being taught the simplified classification system. The primary outcomes were differences in diagnostic accuracy for dysplasia among the three tests. RESULTS: The specificity and overall accuracy improved significantly in the 2nd vs. 1st test [97% vs. 80% (p < 0.001) and 94% vs. 82% (p < 0.001), respectively], but sensitivity was comparable (87% in both tests; p = 0.42). In the 3rd test, the sensitivity and overall accuracy decreased significantly compared with the 2nd test [82% vs. 87% (p < 0.001) and 93% vs. 94% (p < 0.05), respectively], but there was no significant difference in specificity (97% in both tests; p = 0.16). The kappa values for interobserver agreement for the mucosal pattern, vascular pattern, and predicted histology were substantial, and improved significantly in the 2nd vs. 1st test (0.78 vs. 0.59, 0.70 vs. 0.53, and 0.79 vs. 0.66, respectively; p < 0.001 for all). CONCLUSIONS: The simplified NBI classification system may be appropriate for novice endoscopists to use in providing high accuracy and reproducibility.

リンク情報
DOI
https://doi.org/10.1007/s00535-018-01537-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30603885
ID情報
  • DOI : 10.1007/s00535-018-01537-7
  • PubMed ID : 30603885

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