Diagnostic performance of confocal laser endomicroscopy for atrophy and gastric intestinal metaplasia: <scp>A</scp> meta‐analysis

Bai, Tao; Zhang, Lei; Sharma, Stuti; Jiang, Yong; Xia, Jing; Wang, Huan; Qian, Wei; Song, Jun; Hou, Xiao Hua

doi:10.1111/1751-2980.12470

Cited by 13 publications

(7 citation statements)

References 30 publications

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“…The standard criteria for endoscopists to diagnose CAG with CLE are that stomach pits are sparse and there are interstitial widening, irregular arrangement, severely reduced number of gastric pits, dilated openings, and a decreased number of subepithelial capillaries ( 15 ). The criteria for diagnosing IM with CLE are goblet cells, villous‐like pits, absorptive cells, and brush borders ( 16 ) ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

et al. 2022

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Background and AimsChronic atrophic gastritis (CAG) is closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser endomicroscopy (CLE) in CAG missed under WLE biopsy remain unclear.MethodsThis study is a single-center prospective study that included 21 patients from 1,349 patients who underwent WLE and biopsy and whose WLE results confirmed CAG, but pathological results did not. Then, all these patients received CLE examination and underwent targeted biopsies and five-point standard biopsies. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed.ResultsThe pathological results of five-point standard biopsies in 21 patients confirmed CAG, and 17 patients (81.0%) were confirmed to have intestinal metaplasia (IM). According to the image diagnosis of CLE, there were 19 cases (90.5%) of CAG and 14 cases (66.7%) of IM among these 21 patients. According to the targeted biopsy of CLE, 17 cases (81.0%) of CAG and 14 cases (66.7%) of IM were diagnosed. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p = 0.927), IM severity score (p = 0.250), atrophy scope score (p = 0.781), and IM scope score (p = 0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p = 0.331), but for IM, the diagnosis was the same.ConclusionsCLE can improve the diagnosis rate of CAG and can increase the comprehensive assessment of the scope and severity of CAG.

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Section: Methodsmentioning

confidence: 99%

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

et al. 2022

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“…La calidad de la evidencia fue moderada. Otra revisión sistemática (34) evaluó la exactitud diagnóstica de la endoscopia acompañada de endomicroscopía confocal láser para la detección de metaplasia intestinal gástrica. Se documentó una sensibilidad de 0.93 (IC 95% 0.91 a 0.94) y una especificidad de 0.98 (IC 95% 0.98 a 0.98), lo que corresponde a un LR + de 46.0 junto con un LRde 0.07.…”

Section: Endomicroscopía Confocal Láserunclassified

Guía de práctica clínica para la prevención primaria y secundaria y diagnóstico temprano de cáncer gástrico

Oliveros_wilches

Grillo‐Ardila

Vallejo-Ortega

et al. 2022

Rev. colomb. cancerol.

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Objetivo: Generar recomendaciones basadas en la evidencia, para la prevención primaria y secundaria, el tratamiento de las lesiones preneoplásicas y el diagnóstico temprano del cáncer gástrico en población adulta, con el propósito de reducir la carga de la enfermedad. Materiales y métodos: El grupo desarrollador estuvo integrado por profesionales de la salud y tomadores decisiones. Se construyeron preguntas clínicas contestables y se realizó la graduación de los desenlaces. Se elaboró la busqueda de la información en MEDLINE; EMBASE y CENTRAL, siendo actualizada el 18 de octubre de 2018. La pesquisa también abarcó otras fuentes de información como la Revista Colombiana de Gastroenterología y la lectura en “bola de nieve” de las referencias incluidas. Se contactó expertos en la materia con el objeto de identificar estudios relevantes no publicados. Para la construcción de las recomendaciones, se realizó un consenso acorde a los lineamientos propuestos por la metodología GRADE, sopesando a los beneficios, los efectos adversos derivados de la intervención, las preferencias de los pacientes y el potencial impacto de las intervenciones sobre los costos. Resultados: Se presenta la versión corta de la “Guía de práctica clínica para la prevención primaria, secundaria y diagnóstico temprano de cáncer gástrico” junto su evidencia de soporte y respectivas recomendaciones. Conclusiones: Como recomendación central para la implementación se recomienda erradicar la infección por H. pylori en los pacientes con o sin factores de riesgo como estrategia de prevención de las condiciones precursoras de cáncer gástrico. La Guía deberá actualizarse en tres años.

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“…The standard criteria for endoscopists to diagnose CAG with CLE is that stomach pits are sparse, interstitial widening, irregular arrangement, severely reduced number of gastric pits, dilated openings, decreased number of subepithelial capillaries 17 . The criteria for diagnosing IM with CLE are goblet cells, villous-like pits, absorptive cells and brush borders 18 . (Fig.…”

Section: Cle Proceduresmentioning

confidence: 99%

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

Pang

Shi

Yao

et al. 2021

Preprint

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Background: Chronic atrophic gastritis (CAG) are closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser microscopy (CLE) in CAG missed under WLE biopsy remains unclear.Methods: This study is a single-center prospective study that included 21 patients who were diagnosed with CAG under WLE, and whose pathological results were chronic inflammation. Then, all these patients received a CLE examination and endoscopic features were evaluated. All patients underwent targeted biopsies and five-point standard biopsies under CLE. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed by using the five-point standard biopsy pathological results.Results: The pathological results of five-point standard biopsies in 21 patients were CAG, and 17 patients (81.0%) were intestinal metaplasia (IM). According to the image diagnosis under CLE, 19 of these 21 patients (90.5%) were diagnosed with CAG, and 14 of them (66.7%) were diagnosed with IM. According to the targeted biopsy under CLE, 17 (81.0%) patients were diagnosed with CAG, and 14 of them (66.7%) were diagnosed with IM. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p=0.927), IM severity score (p=0.250), atrophy scope score (p=0.781) and IM scope score (p=0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p=0.331). For IM, the sensitivity, specificity and accuracy of CLE image diagnosis were the same as those of CLE targeted biopsies.Conclusions: CLE can improve the diagnosis rate of CAG, and can increase the comprehensive assessment of the scope and severity of CAG.

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Diagnostic performance of confocal laser endomicroscopy for atrophy and gastric intestinal metaplasia: A meta‐analysis

Abstract: CLE is of great value and may be considered an alternative modality for the early diagnosis of GA and GIM.

Cited by 13 publications

References 30 publications

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

Guía de práctica clínica para la prevención primaria y secundaria y diagnóstico temprano de cáncer gástrico

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

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