Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) andLugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamouscell neoplasms (ESCNs) in patients with a history of head and neck cancer. Methods: From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology hashistorically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictivevalue (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined. Results: Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelialneoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy ofdNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively. Conclusions: The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detectingesophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guidedbiopsy could reduce the number of unnecessary biopsies.
Abstract
Background/Aims: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) andLugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamouscell neoplasms (ESCNs) in patients with a history of head and neck cancer. Methods: From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology hashistorically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictivevalue (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined. Results: Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelialneoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy ofdNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively. Conclusions: The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detectingesophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guidedbiopsy could reduce the number of unnecessary biopsies.
참고문헌 (22)
- Jemal A, "Global cancer statistics", CA Cancer J Clin, 61, pp.69~90 (2011)
- Wang GQ, "Long-term results of operation for 420 patients with early squamous cell esophageal carcinoma discovered by screening", Ann Thorac Surg, 77, pp.1740~1744 (2004)
- Rustgi AK, "Esophageal carcinoma", N Engl J Med, 371, pp.2499~2509 (2014)
- Katada C, "Clinical outcome after endoscopic mucosal resection for esophageal squamous cell carcinoma invading the muscularis mucosae--a multicenter retrospective cohort study", Endoscopy, 39, pp.779~783 (2007)
- Hirota WK, "ASGE guideline : the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract", Gastrointest Endosc, 63, pp.570~580 (2006)
- Freitag CP, "Esophageal dysplasias are detected by endoscopy with Lugol in patients at risk for squamous cell carcinoma in southern Brazil", Dis Esophagus, 12, pp.191~195 (1999)
- Prueksapanich P, "Value of probe-based confocal laser endomicroscopy(pCLE)and dual focus narrow-band imaging(dNBI)in diagnosing early squamous cell neoplasms in esophageal Lugol’s voiding lesions", Endosc Int Open, 3, pp.E281~E288 (2015)
- Lee CT, "Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers", Endoscopy, 42, pp.613~619 (2010)
- Takenaka R, "Narrow-band imaging provides reliable screening for esophageal malignancy in patients with head and neck cancers", Am J Gastroenterol, 104, pp.2942~2948 (2009)
- Nagami Y, "Usefulness of non-magnifying narrow-band imaging in screening of early esophageal squamous cell carcinoma : a prospective comparative study using propensity score matching", Am J Gastroenterol, 109, pp.845~854 (2014)
- Chen MC, "The incidence and risk of second primary cancers in patients with nasopharyngeal carcinoma : a population-based study in Taiwan over a 25-year period(1979-2003)", Ann Oncol, 19, pp.1180~1186 (2008)
- Inoue H, "Magnification endoscopy in esophageal squamous cell carcinoma : a review of the intrapapillary capillary loop classification", Ann Gastroenterol, 28, pp.41~48 (2015)
- Hashimoto CL, "Lugol’s dye spray chromoendoscopy establishes early diagnosis of esophageal cancer in patients with primary head and neck cancer", Am J Gastroenterol, 100, pp.275~282 (2005)
- Liu H, "Confocal laser endomicroscopy for superficial esophageal squamous cell carcinoma", Endoscopy, 41, pp.99~106 (2009)
- Lee YC, "Transnasal endoscopy with narrow-band imaging and Lugol staining to screen patients with head and neck cancer whose condition limits oral intubation with standard endoscope(with video)", Gastrointest Endosc, 69, pp.408~417 (2009)
- Day GL, "Second primary tumors in patients with oral cancer", Cancer, 70, pp.14~19 (1992)
- Priante AV, "Second primary tumors in patients with head and neck cancer", Curr Oncol Rep, 13, pp.132~137 (2011)
- Schwartz LH, "Synchronous and metachronous head and neck carcinomas", Cancer, 74, pp.1933~1938 (1994)
- Goda K, "Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial", Endoscopy, 48, pp.321~329 (2016)
- Dawsey SM, "Squamous esophageal histology and subsequent risk of squamous cell carcinoma of the esophagus. A prospective follow-up study from Linxian, China", Cancer, 74, pp.1686~1692 (1994)
- Su YY, "Effect of routine esophageal screening in patients with head and neck cancer", JAMA Otolaryngol Head Neck Surg, 139, pp.350~354 (2013)
- Li J, "Lugol chromoendoscopy detects esophageal dysplasia with low levels of sensitivity in a high-risk region of China", Clin Gastroenterol Hepatol, 16, pp.1585~1592 (2018)