Effect of magnifying endoscopy with narrow-band imaging in diagnosis of early gastric neoplastic lesion / 中国内镜杂志

ABSTRACT

Objective To investigate the effect of magnifying endoscopy with narrow-band imaging (ME-NBI) in diagnosis of early gastric neoplastic lesion. Methods 151 patients with suspected gastric cancer underwent endoscopic examination in digestive endoscopy center from January 2013 to June 2016 were enrolled the study. They firstly received conventional white light endoscopy (WLE), then ME-NBI (including intervening part) and targeted biopsy. And all patients were divided into early cancer group (high grade intraepithelial neoplasia, intramucosal carcinoma and submucosal carcinoma, n = 72) and non-early cancer group (low grade intraepithelial neoplasia, n = 79). The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in early cancer. Results The incidences of the demarcation line, irregular microvascular pattern, irregular microsurface pattern and increasing intervening part in early cancer group were significantly higher than that in the non-early cancer group (P < 0.05). The AUC of ME-NBI for early gastric cancer was 0.947 and higher than 0.832 of WLE. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index were 97.2%, 84.8%, 85.4%, 97.1% and 0.820, respectively. The AUC of intervening part for early gastric cancer was 0.907 and higher than 0.889 of the traditional VS classification, and AUC, sensitivity, specificity, PPV, NPV and Youden index of VS type combined with intervening part were 0.933, 95.8%, 83.5%, 84.1%, 95.7% and 0.794, respectively. Conclusions ME-NBI is an important method for diagnosis of early gastric cancer, and intervening part has the advantages of strong objectivity, simple and easy to operate, good repeatability, and it could be used to assist traditional VS classification in judging the nature of lesions.