Magnifying image-enhanced endoscopy-only mode boosted early cancer diagnostic efficiency: a multicenter randomized controlled trial.

Autor: Jiang AR; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Gastroenterology, The People's Hospital of Wansheng District, Chongqing, China., Wen LM; Department of Gastroenterology, Sichuan MianYang 404 Hospital, Sichuan, China., Ding JW; Department of Gastroenterology, The People's Hospital of Tongliang District, Chongqing, China., Zou RZ; Department of Gastroenterology, The People's Hospital of Chongqing LiangJiang New Area, Chongqing, China., Nie XB; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Lin H; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Epidemiology, Army Medical University, Chongqing, China., Chen J; Department of Gastroenterology, Chongqing University Three Gorges Hospital, Chongqing, China., Zhang WS; Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China., Dan LY; Department of Gastroenterology, The People's Hospital of Tongliang District, Chongqing, China., Zhu YX; Department of Gastroenterology, The People's Hospital of Chongqing LiangJiang New Area, Chongqing, China., Ren CM; Department of Gastroenterology, Sichuan MianYang 404 Hospital, Sichuan, China., Wu YY; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Sheng LL; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Chen DR; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Liao GB; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Gastroenterology, The 901 Hospital of Chinese People's Liberation Army Joint Service Support Unit, Hefei, China., Zhao HY; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Li JJ; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Zuo Y; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Chen J; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Bai JY; Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China., Xu LB; Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China., Yu S; Department of Gastroenterology, Chongqing University Three Gorges Hospital, Chongqing, China.
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2023 Dec; Vol. 98 (6), pp. 934-943.e4. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1016/j.gie.2023.06.068
Abstrakt: Background and Aims: Magnifying image-enhanced endoscopy (MIEE) is an advanced endoscopy with image enhancement and magnification used in preoperative examination. However, its impact on the detection rate is unknown.
Methods: We conducted an open-label, randomized, parallel (1:1:1), controlled trial in 6 hospitals in China. Patients were recruited between February 14, 2022 and July 30, 2022. Eligible patients were aged ≥18 years and undergoing gastroscopy in outpatient departments. Participants were randomly assigned to the MIEE-only mode (o-MIEE) group, white-light endoscopy-only mode (o-WLE) group, and MIEE when necessary mode (n-MIEE) group (initial WLE followed by switching to another endoscope with MIEE if necessary). Biopsy sampling of suspicious lesions of the lesser curvature of the gastric antrum was performed. Primary and secondary aims were to compare detection rates and positive predictive value (PPV) of early cancer and precancerous lesions in these 3 modes, respectively.
Results: A total of 5100 recruited patients were randomly assigned to the o-MIEE (n = 1700), o-WLE (n = 1700), and n-MIEE (n = 1700) groups. In the o-MIEE, o-WLE, and n-MIEE groups, 29 (1.51%; 95% confidence interval [CI], 1.05-2.16), 4 (.21%; 95% CI, .08-.54), and 8 (.43%; 95% CI, .22-.85) early cancers were found, respectively (P < .001). The PPV for early cancer was higher in the o-MIEE group compared with the o-WLE and n-MIEE groups (63.04%, 33.33%, and 38.1%, respectively; P = .062). The same trend was seen for precancerous lesions (36.67%, 10.00%, and 21.74%, respectively).
Conclusions: The o-MIEE mode resulted in a significant improvement in diagnosing early upper GI cancer and precancerous lesions; thus, it could be used for opportunistic screening. (Clinical trial registration number: ChiCTR2200064174.).
Competing Interests: Disclosure All authors disclosed no financial relationships. Research support for this study was provided by the Clinical Research Personnel Training Program (2018XLC1009), the Outstanding Talent Pool Key Support Object Projects of Army Medical University, and Chongqing Health Appropriate Technology Promotion Project (2022jstg033).
(Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: