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Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial 期刊论文

编号：

904ff6ec-1173-4442-b91c-e4be36240c93
作者：

Protano, MarionAnna#^[1]Xu, Hong(徐红)#^[4]Wang, Guiqi(王贵齐)#^[6]Polydorides, Alexandros D.^[2];Dawsey, Sanford M.^[8];Cui, Junsheng^[5];Xue, Liyan^[7];Zhang, Fan(张帆)^[4]Quang, Timothy^[9];Pierce, Mark C.^[10];Shin, Dongsuk^[9];Schwarz, Richard A.^[9];Bhutani, Manoop S.^[11];Lee, Michelle^[1];Parikh, Neil^[12];Hur, Chin^[13,14];Xu, Weiran(徐为然)^[4]Moshier, Erin^[3];Godbold, James^[3];Mitcham, Josephine^[1];Hudson, Courtney^[1];RichardsKortum, Rebecca R.^[9];Anandasabapathy, Sharmila*^[1]
语种：

英文
期刊：

GASTROENTEROLOGY ISSN：0016-5085 2015 年 149 卷 2 期 (321 - 329) ; AUG
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关键词：

Esophageal Neoplasm Endoscopy Early Detection of Cancer
摘要：

BACKGROUND & AIMS: Esophageal squamous cell neoplasia has a high mortality rate as a result of late detection. In high-risk regions such as China, screening is performed by Lugol"s chromoendoscopy (LCE). LCE has low specificity, resulting in unnecessary tissue biopsy with a subsequent increase in procedure cost and risk. The purpose of this study was to evaluate the accuracy of a novel, low-cost, high-resolution microendoscope (HRME) as an adjunct to LCE. METHODS: In this prospective trial, 147 consecutive high-risk patients were enrolled from 2 US and 2 Chinese tertiary centers. Three expert and 4 novice endoscopists performed white-light endoscopy followed by LCE and HRME. All optical images were compared with the gold standard of histopathology. RESULTS: By using a per-biopsy analysis, the sensitivity of LCE vs LCE + HRME was 96% vs 91% (P = .0832), specificity was 48% vs 88% (P < .001), positive predictive value was 22% vs 45% (P < .0001), negative predictive value was 98% vs 98% (P = .3551), and overall accuracy was 57% vs 90% (P < .001), respectively. By using a per-patient analysis, the sensitivity of LCE vs LCE + HRME was 100% vs 95% (P = .16), specificity was 29% vs 79% (P < .001), positive predictive value was 32% vs 60%, 100% vs 98%, and accuracy was 47% vs 83% (P < .001). With the use of HRME, 136 biopsies (60%; 95% confidence interval, 53%-66%) could have been spared, and 55 patients (48%; 95% confidence interval, 38%-57%) could have been spared any biopsy. CONCLUSIONS: In this trial, HRME improved the accuracy of LCE for esophageal squamous cell neoplasia screening and surveillance. HRME may be a cost-effective optical biopsy adjunct to LCE, potentially reducing unnecessary biopsies and facilitating real-time decision making in globally underserved regions. ClinicalTrials.gov, NCT 01384708.
推荐引用方式
GB/T 7714：

Protano Marion-Anna,Xu Hong,Wang Guiqi, et al. Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial [J].GASTROENTEROLOGY,2015,149(2):321-329.
APA：

Protano Marion-Anna,Xu Hong,Wang Guiqi,Polydorides Alexandros D.,&Anandasabapathy Sharmila.(2015).Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial .GASTROENTEROLOGY,149(2):321-329.
MLA：

Protano Marion-Anna, et al. "Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial" .GASTROENTEROLOGY 149,2(2015):321-329.
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