Magnifying Endoscopy Combined with Narrow-band Imaging for Targeted Biopsy of Superficial Lesions in Esophagus
10.3969/j.issn.1008-7125.2016.10.004
- VernacularTitle:放大内镜结合窄带成像在食管浅表性病变靶向活检中的应用价值
- Author:
Fangjun WANG
;
Pengfei LIU
;
Ke ZHAO
;
Yi GAO
;
Bingtuan LIU
;
Huamin LIU
- Publication Type:Journal Article
- Keywords:
Esophageal Neoplasms;
Magnifying Endoscopy;
Narrow-Band Imaging;
Targeted Biopsy;
Diagnosis
- From:Chinese Journal of Gastroenterology
2016;21(10):597-601
- CountryChina
- Language:Chinese
-
Abstract:
Background:Esophageal cancer is a commonly seen gastrointestinal malignancy. Early detection of superficial neoplastic lesions is critical for improving the prognosis. Therefore,it is of great importance to explore new endoscopic techniques for increasing the detection rate of early esophageal cancer. Aims:To assess the diagnostic accuracy of targeted biopsy guided by magnifying endoscopy combined with narrow-band imaging(ME-NBI)for suspected superficial lesions in esophagus. Methods:In a prospective cross-over designed trial,65 patients with suspected superficial lesions in esophagus detected by conventional gastroscopy were randomly assigned to group A and group B. Patients in group A received primary white light imaging(WLI)with Lugol’s staining followed by ME-NBI 4-6 weeks later,and patients in group B received primary ME-NBI followed by WLI with Lugol’s staining 4-6 weeks later. Random biopsy was performed in WLI with Lugol’s staining,while targeted biopsy was performed in ME-NBI based on Inoue’s intraepithelial papillary capillary loop (IPCL)classification. Results:A total of 58 patients completed the study and 68 lesions were eligible for statistical analysis. More biopsies were taken in WLI with Lugol’s staining than in ME-NBI(3. 7 vs. 2. 2 per lesion,P < 0. 05). The overall agreement of IPCL classification with definite pathological diagnosis was 89. 7% . The overall agreement of targeted biopsy by ME-NBI and random biopsy by WLI with Lugol’s staining was 85. 3% ;the specificity and positive predictive value of both ME-NBI and WLI with Lugol’s staining for neoplastic lesions were 100% ,but the sensitivity of ME-NBI was superior to that of WLI with Lugol’s staining(90. 0% vs. 70. 0% ,P < 0. 05). The agreement of ME-NBI-guided targeted biopsy with definite pathological diagnosis was slightly higher than that of random biopsy by WLI with Lugol’s staining(89. 7% vs. 86. 8% ,P > 0. 05). Conclusions:ME-NBI-guided targeted biopsy is superior to random biopsy by WLI with Lugol’s staining for detection of superficial neoplastic lesions in esophagus with higher sensitivity and less number of biopsy. It might benefit the follow-up endoscopic treatment.
