Confocal laser endomicroscopy for differential diagnosis of gastric ulcer
10.3760/cma.j.issn.0254-1432.2010.01.002
- VernacularTitle:共聚焦激光显微内镜对胃部溃疡型病变的鉴别诊断价值
- Author:
Tao LI
;
Yanqing LI
;
Xiaomeng GU
;
Tao YU
;
Wenbo LI
;
Rui JI
;
Zhen HE
- Publication Type:Journal Article
- Keywords:
Gastric ulcer;
Stomach neoplasms;
Microscopy;
confocal;
Diagnosis
- From:
Chinese Journal of Digestion
2010;30(1):3-6
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the value of confocal laser endomicroscopy (CLE)for differential diagnosis of gastric ulcer. Methods Patients diagnosed as gastric ulcer by conventional endoscopic mode of CLE were enrolled. The eonfocal endoscopic mode of CLE was used to observe the borderline and/or the surface of the ulcers. Biopsy specimen was taken for histopathological examination and the result of CLE was compared with histopathological finding. Results A total of 12 769 CLE images were obtained from 150 sites of 43 patients. The sensitivity and specificity of CLE for phlegmonosis process were 83.54% and 85.92%, respectively, with positive predictive value of 86.84% and negative predictive value of 82.43%. Whereas the sensitivity and specificity of CLE for intraepithelial neoplasia were 53.57% and 88.52%, respectively, with positive predictive value of 51.72% and negative predictive value of 89.26%. As for diagnosis of gastric cancer, the sensitivity and specificity of CLE were 88.37% and 93.46%, respectively, with positive predictive value of 84.44 % and negative predictive value of 95.24%. The kappa values for agreement of histopathological findings and CLE for diagnosis of phlegmonosis process, intraepithelial neoplasia and gastric cancer were 0.69,0.42 and 0.81, respectively. Conclusions CLE can provide a real-time histopathological diagnosis of the gastrointestinal tract with high sensitivity, specificity, positive and negative predictive values. Targeted biopsy can be done under CLE and the detective rates of precancerous lesions and tumors will be increased.
