論文

国際誌
2020年12月15日

Diagnostic yield of fourth-generation endocytoscopy for esophageal squamous lesions using a modified endocytoscopic classification.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
  • Yuto Shimamura
  • ,
  • Haruhiro Inoue
  • ,
  • Enrique Rodriguez de Santiago
  • ,
  • Mary Raina Angeli Abad
  • ,
  • Yusuke Fujiyoshi
  • ,
  • Akiko Toshimori
  • ,
  • Mayo Tanabe
  • ,
  • Kazuya Sumi
  • ,
  • Yugo Iwaya
  • ,
  • Haruo Ikeda
  • ,
  • Manabu Onimaru
  • ,
  • Miki Kushima
  • ,
  • Kenichi Goda

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/den.13914

OBJECTIVES: Endocytoscopy (EC) is an ultra-high magnification endoscopy designed to provide in vivo histologic assessment. This study aimed to evaluate the diagnostic yield of the newly developed fourth-generation EC for esophageal squamous lesions by using a modified EC classification. METHODS: A total of 2548 EC images of 57 esophageal targeted areas between June 2015 and October 2017 were retrospectively collected. Two lesions with low-quality images were excluded. Only EC images were independently reviewed by two expert and two non-expert endoscopists. The lesions were classified according to a three-tier modified EC classification. We used a multilevel logistic regression to analyze the data. RESULTS: The sensitivity and specificity of diagnosing non-squamous cell cancer (SCC) vs SCC were 82.5% and 83.0% by the experts; 90.1% and 75.0% by non-experts. The interobserver agreement among the four raters was good (kappa statistic 0.59). The diagnostic accuracy of experts and non-experts was similar (P = 0.16 for specificity and P = 0.20 for sensitivity). The sensitivity and specificity of EC for non-neoplasia vs neoplasia were 88.7% and 74.6% by experts; 90.3 and 52.1% by non-experts. The interobserver agreement among the four raters was moderate (kappa statistic 0.44). The specificity of experts was higher compared to non-experts, although the difference did not reach statistical significance (P = 0.08 for specificity and P = 0.93 for sensitivity). CONCLUSIONS: Fourth-generation EC offers acceptable diagnostic accuracy and reliability in both experts and non-experts, especially when diagnosing SCC lesions.

リンク情報
DOI
https://doi.org/10.1111/den.13914
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33320375
ID情報
  • DOI : 10.1111/den.13914
  • PubMed ID : 33320375

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