The value of target biopsy using magnifying endoscopy combined with narrow band imaging for early gastric malignancy

Abstract

Objective To evaluate target biopsy using magnifying endoscopy combined with narrow band imaging（ME-NBI） in suspicious gastric lesions. Methods A total of 113 patients with suspicious early gastric lesions under white light endoscopy（WLE） were prospectively enrolled and biopsied between May 2011 and May 2013. Further endoscopy was conducted using ME-NBI and target biopsy. All patients received endoscopic resection（ER）. Outcomes of WLE biopsy and target biopsy were compared, with histology of ER specimen as golden standard. Results The overall diagnostic accuracy of WLE biopsy and target biopsy were 22. 1% （25/113） and 54.0% （61/113）, （P 〈 0.0001 ）. In diagnosing early gastric cancer （EGC） and high-grade intraepithelial neoplasia （ HGIN）, the sensitivity of target and WLE biopsy were 70. 9% and 37. 9% （P 〈0. 0001 ）, respectively. The specificity were 90. 0% in both groups. The accuracy rates were 72. 6% and 42. 5%, respectively（P 〈0. 0001 ）. The positive predictive values were 98. 6% and 97. 5% （P 〉0. 05）. The negative predictive values were 23.1% and 12. 3% （P 〉0. 05）, respectively. The overall progression rate of target biopsy was 46.9% （53/113）. Conclusion ME-NBI target biopsy is superior to traditional WLE biopsy in diagnosis of early gastric cancer. Key words: Stomach neoplasms ; Endoscopes ; Treatment outcome ; Pathology