Multicenter, prospective trial of white-light imaging alone versus white-light imaging followed by magnifying endoscopy with narrow-band imaging for the real-time imaging and diagnosis of invasion depth in superficial esophageal squamous cell carcinoma

作者：Ebi Masahide; Shimura Takaya^*; Yamada Tomonori; Mizushima Takashi; Itoh Keisuke; Tsukamoto Hironobu; Tsuchida Kenji; Hirata Yoshikazu; Murakami Kenji; Kanie Hiroshi; Nomura Satoshi; Iwasaki Hiroyasu; Kitagawa Mika; Takahashi Satoru; Joh Takashi

来源：Gastrointestinal Endoscopy, 2015, 81(6): 1355-+.

DOI：10.1016/j.gie.2014.11.015

Background: Magnifying endoscopy with narrow-band imaging (ME-NBI) has been used to estimate the invasion depth of superficial esophageal squamous cell carcinoma (SESCC), but the real diagnostic power of ME-NBI remains unclear because of few prospective studies.
Objectives: To evaluate whether ME-NBI adds additional information to white-light imaging (WLI) for the diagnosis of invasion depth of SESCC.
Design: Multicenter, prospective trial using real-time imaging and diagnosis.
Setting: Seven Japanese institutions.
Patients: Fifty-five patients with SESCC were enrolled from June 2011 to October 2013, and the results for 49 lesions were analyzed.
Interventions: Patients underwent primary WLI followed by ME-NBI, and reports of primary WLI (WLI alone) were completed before secondary ME-NBI (WLI followed by ME-NBI). To standardize diagnosis among examiners, this trial was started after achievement of a mean kappa value >= .6 among 11 participating endoscopists.
Main Outcome Measurements: Diagnosis of invasion depth by each tool was divided into cancer limited to the epithelium and the lamina propria mucosa and cancer invading beyond the muscularis mucosae (>= T1a-MM) and then collated with the final pathologic diagnosis by an independent pathologist blinded to the clinical data.
Results: The accuracy of invasion depth in WLI alone and WLI followed by ME-NBI was 71.4% and 65.3% (P = .375), respectively. Sensitivity for >= T1a-MM was 61.1% for both groups (P = 1.000), and specificity for >= T1a-MM was 77.4% for WLI alone and 67.7% for WLI followed by ME-NBI (P = .375).
Limitation: Open-label trial.
Conclusions: ME-NBI showed no additional benefit to WLI for diagnosis of invasion depth of SESCC.

• 出版日期2015-6