Diagnostic value of confocal laser endomicroscopy for non-protruding gastric lesions / 中华消化内镜杂志

ABSTRACT

Objective To discuss the differential diagnostic value of confocal laser endomicroscopy (CLE)for benign and malignant non-protruding gastric lesions.Methods A total of 37 patients with nonprotruding gastric lesions diagnosed by conventional gastroscopy underwent CLE.Fluorescein sodium was intravenously injected,and target biopsy was obtained.Malignant lesionss diagnosed with CLE or biopsy were treated by endoscopy or surgery.Patients with benign lesions were give routine medication and followed up every 3 months until the lesions were cured.Results CLE diagnosed 11 malignant and 26 benign lesions.However,1 of 11 cancers was confirmed as benign by histopathology,while 1 of 26 benign lesions was confirmed cancer.Lesions in 12 patients were resected,with 3 by endoscopy,and 9 by surgery,and findings of post-operative pathology were consistent with those of target biopsy.No malignancy was found during the follow-up of benign lesions,and all lesions were healed after 3.16(3.58 ± 1.20)months.The sensitivity,specificity,and accuracy of CLE in diagnosis of malignant non-protruding gastric lesion were 90.9％,96.2％,and 90.9％,respectively.The positive and negative predictive values were 90.9％ and 96.2％,respectively.The Kappa value of CLE and histopathology was 0.871.Conclusion CLE is of significant value for the diagnosis of non-protruding gastric lesions,and may replace biopsy in real-time histological diagnosis.