Application of magnifying endoscopy with narrow-band imaging in diagnosing gastric lesions: a prospective study

Hy, Li; Dai, Jing; Hb, Xue; Zhao, Yang; Xy, Chen; Yj, Gao; Song, Yan; Zz, Ge; Xb, Li

doi:10.1016/j.gie.2012.08.015

Cited by 56 publications

(57 citation statements)

References 23 publications

(22 reference statements)

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“…On the basis of this standard, published studies have reported that ME-NBI has a high diagnostic efficacy. However, there is a large difference in the sensitivity among these studies, ranging from 0.60 to 0.97 [13,14,18]. To our knowledge, our study is the first meta-analysis focusing on systematically evaluating the diagnostic efficacy of ME-NBI for early gastric cancer.…”

Section: Discussionmentioning

confidence: 98%

“…However, there are limitations in assessment of the depth of invasion. Some patients still need further surgery after gastric ESD or endoscopic mucosal resection [13].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the differences in the experience level of the endoscopists among the studies included may also be a factor contributing to heterogeneity. Only four studies [13,14,16,20] clearly described the experience level of the endoscopists, and there were significant differences regarding the level of experience with respect to the total number of cases and the time spent performing ME-NBI among these studies. Moreover, there were significant differences in the experience level of the endoscopists in a single study.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of endoscopic techniques, magnifying endoscopy with narrow band imaging (ME-NBI) has been used in the diagnosis of gastric diseases, especially early gastric cancer. Studies have reported the sensitivity of ME-NBI for diagnosis of early gastric cancer ranges from 0.60 to 0.97 [13,14], which shows there are distinct differences among the studies. Therefore, the purpose of this study was to conduct a meta-analysis to compare the diagnostic efficacy of WLI and ME-NBI for early gastric cancer.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 96%

“…However, there was still significant heterogeneity among the studies. In addition, we sequentially excluded the following studies, which significantly deviated from the pooled effect size, to perform the analysis: the studies of Li et al [13], Maki et al [17], Tao et al [21], and Kato et al [16]. Sensitivity analyses were performed on the remaining eight, seven, and six studies.…”

Section: Sensitivity Analysis and Meta-regression Analysismentioning

confidence: 99%

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Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis

et al. 2015

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Objective Magnifying endoscopy with narrow band imaging (ME-NBI) is widely used in gastroscopy, especially in the diagnosis of early gastric cancer. The purpose of this meta-analysis is to compare the diagnostic efficacy of white light imaging (WLI) and that of ME-NBI for early gastric cancer. Methods PubMed/MEDLINE, EMBASE, and the Cochrane Library were searched to identify studies which met the inclusion criteria. A random-effects model was used to calculate overall sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) to assess the diagnostic efficacy of WLI and ME-NBI in early gastric cancer. Sensitivity analysis was performed to assess the stability of the results. Results Ten studies met the inclusion criteria, and included 1724 patients and 2153 lesions. The pooled sensitivity, specificity, and AUC for the diagnosis of early gastric cancer using WLI were 0.48 [95 % confidence interval (CI) 0.39-0.57; I 2 = 78.6 %], 0.67 (95 % CI 0.62-0.71; I 2 = 81.9 %), and 0.62, respectively. The pooled sensitivity, specificity, and AUC using ME-NBI were 0.83 (95 % CI 0.79-0.87; I 2 = 79.8 %), 0.96 (95 % CI 0.95-0.97; I 2 = 89.3 %), and 0.96, respectively. The studies showed a high degree of heterogeneity. Further sensitivity analysis was mainly performed for the studies of small lesions (mean size 10 mm or less) and the studies with a the score of 12 points or greater in the literature quality assessment, and the AUCs for ME-NBI for diagnosis of early gastric cancer were between 0.93 and 0.98, which suggested that the diagnostic value was still high and stable. Conclusion Compared with WLI, ME-NBI can effectively diagnose early gastric cancer.

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Section: Discussionmentioning

confidence: 98%

“…However, there are limitations in assessment of the depth of invasion. Some patients still need further surgery after gastric ESD or endoscopic mucosal resection [13].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Electronic Supplementary Materialsmentioning

confidence: 96%

Section: Sensitivity Analysis and Meta-regression Analysismentioning

confidence: 99%

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Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis

et al. 2015

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Diagnosis of histological type of early gastric cancer by magnifying narrow‐band imaging: A multicenter prospective study

et al. 2021

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Objectives Distinguishing undifferentiated‐type from differentiated‐type early gastric cancers (EGC) is crucial for determining the indication of endoscopic resection. We aimed to investigate the diagnostic performance of white‐light endoscopy (WLE) and magnifying narrow‐band imaging (M‐NBI) for the histological type of EGC. Methods In this multicenter prospective study, patients with histologically proven cT1 EGC, macroscopically depressed or flat type, size ≥5 mm, and without erosion/ulcer, were recruited. The diagnostic criterion of WLE for undifferentiated‐type EGC was pale color. The M‐NBI algorithm was created based on microsurface and microvascular patterns, and lesions with absent microsurface pattern and opened‐loop microvascular patterns were diagnosed as undifferentiated‐type. The center of the lesion was defined as the evaluation point and was initially evaluated by WLE, then by M‐NBI, and a biopsy specimen was taken as a reference standard. The primary and key secondary endpoints were overall diagnostic accuracy and specificity, respectively. Results In total, 167 lesions (122 differentiated‐type and 45 undifferentiated‐type EGCs) in 167 patients were analyzed. The overall accuracy, sensitivity, specificity, and positive likelihood ratio of WLE for undifferentiated‐type cancer were 80%, 69%, 84%, and 4.4, respectively, and those of M‐NBI were 82%, 53%, 93%, and 7.2, respectively. There was no significant difference in overall accuracy ( p = 0.755), but specificity was significantly higher in M‐NBI ( p = 0.041). Conclusions The use of M‐NBI did not improve the accuracy of WLE for the diagnosis of depressed/flat undifferentiated‐type EGCs but improved the specificity. It may reduce surgical overtreatment by preventing misdiagnosis of differentiated‐type EGC as undifferentiated‐type.

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Proposal of minimum elements for screening and diagnosis of gastric cancer by an international Delphi consensus

et al. 2022

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The World Endoscopy Organization Stomach and Duodenal Diseases Committee extracted minimum elements for screening and diagnosis of gastric cancer (GC) in aim to support countries that do not have national guidelines on screening and diagnosis of GC. Current national or international guidelines were collected worldwide and recommendations were classified according to the quality of evidence and were finalized through a modified Delphi method. The minimum elements consist of seven categories: [1] Extraction of high‐risk patients of GC before esophagogastroduodenoscopy (EGD), [2] Patients who need surveillance of GC, [3] Method to ensure quality of EGD for detection of GC, [4] Individual GC risk assessment by EGD, [5] Extraction of high‐risk patients of GC after EGD [6] Qualitative or differential diagnosis of GC by EGD, and [7] Endoscopic assessment to choose the therapeutic strategy for GC. These minimum elements will be a guide to promote the elimination of GC among countries with a high incidence of GC who lack national guidelines or screening programs.

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Application of magnifying endoscopy with narrow-band imaging in diagnosing gastric lesions: a prospective study

Cited by 56 publications

References 23 publications

Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis

Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis

Diagnosis of histological type of early gastric cancer by magnifying narrow‐band imaging: A multicenter prospective study

Proposal of minimum elements for screening and diagnosis of gastric cancer by an international Delphi consensus

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