Practice and thinking of standardized training on the diagnosis of early upper gastrointestinal cancer in gastroscopy teaching / 中华医学教育探索杂志

Early upper gastrointestinal cancer screening skills teaching is the vacancy and difficulty of endoscopic teaching and training. In this study, a standardized training program was set up for endoscopic physicians who had mastered the basic gastroscopy techniques. The training period was 12 weeks, including theoretical training, early cancer awareness training, standardized gastroscopy operation technology, endoscopic diagnosis of early esophageal and gastric cancer, and theoretical and skill examination. After passing the examination, trainees can participate in early cancer case competition. According to questionnaire survey, 100%(15/15) of trainees thought that standardized training was necessary for improving the detection rate of early upper gastrointestinal cancer, and it could significantly improve the trainees' diagnosis level. Therefore, the overall setting of the standardized training process for the diagnosis of early upper gastrointestinal cancer in our center is generally reasonable, which is worthy of further promotion.

A meta-analysis of the value of intelligence-assisted endoscopic diagnosis system based on deep learning for early upper gastrointestinal cancer / 中华消化内镜杂志

Objective:To systematically evaluate the intelligence-assisted endoscopic diagnosis system based on deep learning (DL-IEDS) for early cancer of the upper digestive tract.Methods:Literature on the value of DL-IEDS for diagnosis of early cancer of the upper digestive tract was searched in English (PubMed, Embase, Web of Science and Cochrane Library)and Chinese databases (Sinomed, CNKI, Wanfang and VIP). The quality of literatures was evaluated according to Quality Assessment of Diagnostic Accuracy Studies-2. The Rev Man 5.3, Meta-Disc 1.4 and Stata 15.1 were used for the meta-analysis.Results:Eight studies were included with a total of 9 675 images (including 2 748 images of early cancer). Meta-analysis results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and comprehensive diagnostic ratio of DL-IEDS in the diagnosis of early cancer of the upper digestive tract were 0.920, 0.874, 6.824, 0.103 and 71.109, respectively. The area under the curve (AUC) of summary receiver operating characteristics was 0.958 7. Five studies reported the results of DL-IEDS in the diagnosis of early gastric cancer, and the combined analysis showed that the pooled sensitivity and specificity were 0.840 and 0.845 respectively, and the AUC was 0.919. Four studies reported the accuracy rate of endoscopic experts and endoscopic novices in diagnosing early upper gastrointestinal cancer, and results showed that the pooled sensitivity, specificity and AUC were 0.693, 0.892 and 0.892 3, and 0.586, 0.860 and 0.754 5, respectively. Compared with endoscopy experts, the AUC of DL-IEDS in diagnosis of early upper gastrointestinal cancer showed no statistically significant difference ( Z=1.510, P=0.131), while compared with endoscopy novices, the difference was statistically significant ( Z=6.841, P<0.001). Conclusion:The DL-IEDS has high diagnostic accuracy for early upper digestive tract cancer, and can significantly improve the diagnostic ability of endoscopy novices.