Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis
Background and AimsChronic atrophic gastritis (CAG) is closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser endomicroscopy (CLE) in CAG missed under WLE biopsy...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.809822/full |
| _version_ | 1811271635866484736 |
|---|---|
| author | Suya Pang Hailing Yao Chen Jiang Qin Zhang Rong Lin |
| author_facet | Suya Pang Hailing Yao Chen Jiang Qin Zhang Rong Lin |
| author_sort | Suya Pang |
| collection | DOAJ |
| description | Background and AimsChronic atrophic gastritis (CAG) is closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser endomicroscopy (CLE) in CAG missed under WLE biopsy remain unclear.MethodsThis study is a single-center prospective study that included 21 patients from 1,349 patients who underwent WLE and biopsy and whose WLE results confirmed CAG, but pathological results did not. Then, all these patients received CLE examination and underwent targeted biopsies and five-point standard biopsies. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed.ResultsThe pathological results of five-point standard biopsies in 21 patients confirmed CAG, and 17 patients (81.0%) were confirmed to have intestinal metaplasia (IM). According to the image diagnosis of CLE, there were 19 cases (90.5%) of CAG and 14 cases (66.7%) of IM among these 21 patients. According to the targeted biopsy of CLE, 17 cases (81.0%) of CAG and 14 cases (66.7%) of IM were diagnosed. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p = 0.927), IM severity score (p = 0.250), atrophy scope score (p = 0.781), and IM scope score (p = 0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p = 0.331), but for IM, the diagnosis was the same.ConclusionsCLE can improve the diagnosis rate of CAG and can increase the comprehensive assessment of the scope and severity of CAG. |
| first_indexed | 2024-04-12T22:24:35Z |
| format | Article |
| id | doaj.art-ed2afafa7b9544399650139eb43c913b |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T22:24:35Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ed2afafa7b9544399650139eb43c913b2022-12-22T03:14:13ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-03-011210.3389/fonc.2022.809822809822Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological DiagnosisSuya Pang0Hailing Yao1Chen Jiang2Qin Zhang3Rong Lin4Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackground and AimsChronic atrophic gastritis (CAG) is closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser endomicroscopy (CLE) in CAG missed under WLE biopsy remain unclear.MethodsThis study is a single-center prospective study that included 21 patients from 1,349 patients who underwent WLE and biopsy and whose WLE results confirmed CAG, but pathological results did not. Then, all these patients received CLE examination and underwent targeted biopsies and five-point standard biopsies. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed.ResultsThe pathological results of five-point standard biopsies in 21 patients confirmed CAG, and 17 patients (81.0%) were confirmed to have intestinal metaplasia (IM). According to the image diagnosis of CLE, there were 19 cases (90.5%) of CAG and 14 cases (66.7%) of IM among these 21 patients. According to the targeted biopsy of CLE, 17 cases (81.0%) of CAG and 14 cases (66.7%) of IM were diagnosed. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p = 0.927), IM severity score (p = 0.250), atrophy scope score (p = 0.781), and IM scope score (p = 0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p = 0.331), but for IM, the diagnosis was the same.ConclusionsCLE can improve the diagnosis rate of CAG and can increase the comprehensive assessment of the scope and severity of CAG.https://www.frontiersin.org/articles/10.3389/fonc.2022.809822/fullchronic atrophic gastritisgastric cancerwhite light endoscopyconfocal laser endomicroscopypathology |
| spellingShingle | Suya Pang Hailing Yao Chen Jiang Qin Zhang Rong Lin Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis Frontiers in Oncology chronic atrophic gastritis gastric cancer white light endoscopy confocal laser endomicroscopy pathology |
| title | Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis |
| title_full | Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis |
| title_fullStr | Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis |
| title_full_unstemmed | Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis |
| title_short | Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis |
| title_sort | confocal laser endomicroscopy can improve the diagnosis rate and range assessment of patients with conflicting chronic atrophic gastritis results of white light endoscopic and pathological diagnosis |
| topic | chronic atrophic gastritis gastric cancer white light endoscopy confocal laser endomicroscopy pathology |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.809822/full |
| work_keys_str_mv | AT suyapang confocallaserendomicroscopycanimprovethediagnosisrateandrangeassessmentofpatientswithconflictingchronicatrophicgastritisresultsofwhitelightendoscopicandpathologicaldiagnosis AT hailingyao confocallaserendomicroscopycanimprovethediagnosisrateandrangeassessmentofpatientswithconflictingchronicatrophicgastritisresultsofwhitelightendoscopicandpathologicaldiagnosis AT chenjiang confocallaserendomicroscopycanimprovethediagnosisrateandrangeassessmentofpatientswithconflictingchronicatrophicgastritisresultsofwhitelightendoscopicandpathologicaldiagnosis AT qinzhang confocallaserendomicroscopycanimprovethediagnosisrateandrangeassessmentofpatientswithconflictingchronicatrophicgastritisresultsofwhitelightendoscopicandpathologicaldiagnosis AT ronglin confocallaserendomicroscopycanimprovethediagnosisrateandrangeassessmentofpatientswithconflictingchronicatrophicgastritisresultsofwhitelightendoscopicandpathologicaldiagnosis |