期刊
DIGESTIVE DISEASES AND SCIENCES
卷 58, 期 12, 页码 3566-3575出版社
SPRINGER
DOI: 10.1007/s10620-013-2843-2
关键词
Autofluorescence imaging; Narrow-band imaging; Endoscopy; Intestinal metaplasia; Gastric atrophy; Gastric cancer
Detection of pre-neoplastic gastric mucosal changes and early gastric cancer (EGC) by white-light endoscopy (WLE) is often difficult. In this study we investigated whether combined autofluorescence imaging (AFI) and narrow band imaging (NBI) can improve detection of pre-neoplastic lesions and early gastric cancer in high-risk patients. Chinese patients who were 50-years-old or above with dyspepsia were examined by both high-resolution WLE and combined AFI followed by NBI (AFI-NBI), consecutively in a prospective randomized cross-over setting, by two experienced endoscopists. The primary outcome was diagnostic ability of the two methods for patients with pre-neoplastic lesions such as intestinal metaplasia (IM) and mucosal atrophy. Sixty-five patients were recruited. One patient with large advanced gastric cancer was found and excluded from the analysis. Among the remaining 64 patients, 38 (59 %) had IM; of these, 26 (68 %) were correctly identified by AFI-NBI (sensitivity 68 %, specificity 23 %) and only 13 (34 %) by WLE (sensitivity 34 %, specificity 65 %). AFI-NBI detected more patients with IM than did WLE (p = 0.011). Thirty-one patients (48 %) had mucosal atrophy. Ten patients (32 %) were identified by AFI-NBI (sensitivity 32 %, specificity 79 %) and four patients (13 %) by WLE (sensitivity 13 %, specificity 88 %) (p = 0.100). No dysplasia or EGC was found. AFI-NBI identified significantly more patients with IM than did WLE. Our result warrants further studies to define the role of combined AFI-NBI endoscopy for detection of precancerous conditions.
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