Invivo diagnosis of early-stage gastric cancer found after Helicobacter pylori eradication using probe-based confocal laser endomicroscopy

被引：45

作者：

Horiguchi, Noriyuki ^{[1
]}

Tahara, Tomomitsu ^{[1
]}

Yamada, Hyuga ^{[1
]}

Yoshida, Dai ^{[1
]}

Okubo, Masaaki ^{[1
]}

Nagasaka, Mitsuo ^{[1
]}

Nakagawa, Yoshihito ^{[1
]}

Shibata, Tomoyuki ^{[1
]}

Tsukamoto, Tetsuya ^{[2
]}

Kuroda, Makoto ^{[2
]}

Ohmiya, Naoki ^{[1
]}

机构：

[1] Fujita Hlth Univ, Dept Gastroenterol, Sch Med, 1-98 Dengakugakubo,Kutsukake Cho, Toyoake, Aichi 4701192, Japan

[2] Fujita Hlth Univ, Dept Diagnost Pathol 1, Sch Med, Toyoake, Aichi, Japan

来源：

DIGESTIVE ENDOSCOPY | 2018年 / 30卷 / 02期

关键词：

gastric cancer; Helicobacter pylori eradication; magnifying endoscopy with narrow-band imaging; probe-based confocal laser endomicroscopy; white light endoscopy; INFECTION; ENDOSCOPY; FEATURES;

D O I：

10.1111/den.12926

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Background and AimEarly-stage gastric cancer (EGC) found after Helicobacter pylori (Hp) eradication often displays non-tumorous regenerative epithelium and/or maturated tumorous epithelium overlying the cancerous tissue, which may confuse endoscopic and histological diagnosis. Probe-based confocal laser endomicroscopy (pCLE) enables invivo real-time optical biopsy. We compared the diagnostic yields for these EGC cases using conventional white light endoscopy (WL), magnifying endoscopy with narrow-band imaging (ME-NBI), pCLE, and endoscopic biopsy; we also compared the accuracy of the horizontal extent diagnosis between ME-NBI and pCLE. MethodsThis study enrolled 30 patients with 36 EGC lesions after successful Hp eradication. Diagnostic yields of WL, ME-NBI, pCLE, and endoscopic biopsy were prospectively compared. Four points of cancerous margins (oral, anal, anterior, and posterior sites) were also prospectively evaluated with M-NBI and pCLE to determine the horizontal extent of the EGC. ResultsDiagnostic yield was significantly higher with pCLE than with WL and endoscopic biopsy (97 vs 72%, 97 vs 72%, P=0.0159, 0.0077, respectively), whereas it did not differ from ME-NBI (88.9%, P=0.371). Height of non-tumorous regenerative epithelium or maturated atypical glands was 104.734.2m in the pCLE-positive cases, whereas it was 188.3 +/- 27.1m in a pCLE-negative case (P=0.0004). Diagnostic accuracy of the horizontal margin of EGC was significantly higher with pCLE than with ME-NBI (92 vs 70%, P=0.0159). ConclusionpCLE may be helpful for the diagnosis of ambiguous ECG found after Hp eradication because it enables real-time scanning throughout the lesion and detection of subsurface microstructure.

引用

页码：219 / 227

页数：9

共 21 条

[1]

The accuracy of probe-based confocal endomicroscopy versus conventional endoscopic biopsies for the diagnosis of superficial gastric neoplasia (with videos) [J].