Abstract
BackgroundGastric carcinoma is the second commonest cause of cancer deaths worldwide. Early detection and diagnosis of gastric cancer in the stomach is important for improving the prognosis of gastric cancer. This retrospective study was designed to investigate the value of magnifying narrow-band imaging (NBI) in the diagnosis of precancerous lesions and early gastric cancer.MethodsThis study included 122 patients who were diagnosed with early gastric cancer or precancerous gastric lesions by endoscopy. The patients underwent an examination with conventional endoscopy, magnifying NBI, and magnifying chromoendoscopy. Images resolution was evaluated, and the morphology, pit patterns and blood capillary forms of lesions were analyzed. The presence of gastric carcinoma and high grade intraepithelial neoplasia in the biopsy samples was considered as a positive pathological result, which is used to assess accuracy of endoscopic diagnosis.ResultsFor image resolution, magnifying NBI and magnifying chromoendoscopy were significantly superior to magnifying conventional endoscopy in morphology, pit pattern and blood capillary form (P < 0.01), and magnifying NBI was significantly superior to magnifying chromoendoscopy in blood capillary form (P < 0.01). IV, V1, and VI type of gastric pit pattern were detected in 14 cases, 43 cases, and 17 cases in patients with high grade intraepithelial neoplasia, respectively. V1 and VI type of gastric pit pattern were detected in 9 cases and 39 cases in patients with early gastric cancer, respectively. The presence of irregular minute vessels and variation in the caliber of vessels was found in 109 cases. The accuracy, sensitivity, specificity, false positive rate and false negative rate for diagnosis of early gastric cancer and precancerous gastric lesions were 68.9%, 95.1%, 63.1%, 24.5%, and 32.4% for conventional endoscopy, 93.6%, 92.7%, 94.5%, 5.7%, and 6.9% for magnifying NBI, and 91.3%, 88.6%, 93.2%, 13.2%, and 21.48% for magnifying chromoendoscopy, respectively.ConclusionsThis study demonstrates that magnifying NBI is superior to conventional endoscopy in the diagnosis of early gastric cancer and precancerous gastric lesions, and can be used for screening early malignancies of the stomach.
Highlights
Gastric carcinoma is the second commonest cause of cancer deaths worldwide
We found that magnifying narrow-band imaging (NBI) and magnifying chromoendoscopy were significantly superior to magnifying conventional endoscopy in respect of morphology, pit pattern and blood capillary form (P < 0.01), and magnifying NBI is significantly superior to magnifying chromoendoscopy in respect of blood capillary form (P < 0.01)
There is no significant difference between magnifying NBI and magnifying chromoendoscopy with regard to morphology and pit pattern (P > 0.05) (Table 1, Figure 2)
Summary
Detection and diagnosis of gastric cancer in the stomach is important for improving the prognosis of gastric cancer This retrospective study was designed to investigate the value of magnifying narrow-band imaging (NBI) in the diagnosis of precancerous lesions and early gastric cancer. Many studies have reported that this endoscopic imaging modality can increase the rate of diagnosis of early cancers and precancerous lesions by enhancing visualization [5,6], there are few studies about comparison between NBI and conventional endoscopy. This retrospective study was designed to compare the accuracy and sensitivity of magnifying NBI endoscopy with conventional endoscopy and chromoendoscopy for diagnosis of precancerous lesions and early gastric cancer
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