Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms

다국어 초록 (Multilingual 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 (Reference)

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