Comparison of Effective Imaging Modalities for Detecting Gastric Neoplasms: A Randomized 3-Arm Phase II Trial.

Autor:	Kadota T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Abe S; Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan., Uedo N; Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan., Doyama H; Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan., Furue Y; Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan., Muto M; Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Nonaka S; Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan., Takamaru H; Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan., Murano T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Nakajo K; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan., Tani Y; Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan., Okubo Y; Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan., Kawasaki A; Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan., Yoshida N; Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan., Watanabe A; Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan., Katada C; Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan.; Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Tamaoki M; Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Yokoyama A; Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Furuya H; Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan., Ikeno T; Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan., Wakabayashi M; Biostatistics Division, Center for Research Administration and Support, National Cancer Center Hospital East, Kashiwa, Japan., Yano T; Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2024 Oct 01; Vol. 119 (10), pp. 2010-2018. Date of Electronic Publication: 2024 May 16.
DOI:	10.14309/ajg.0000000000002871
Abstrakt:	Introduction: The early detection of gastric neoplasms (GNs) leads to favorable treatment outcomes. The latest endoscopic system, EVIS X1, includes third-generation narrow-band imaging (3G-NBI), texture and color enhancement imaging (TXI), and high-definition white-light imaging (WLI). Therefore, this randomized phase II trial aimed to identify the most promising imaging modality for GN detection using 3G-NBI and TXI. Methods: Patients with scheduled surveillance endoscopy after a history of esophageal cancer or GN or preoperative endoscopy for known esophageal cancer or GN were randomly assigned to the 3G-NBI, TXI, or WLI groups. Endoscopic observations were performed to detect new GN lesions, and all suspected lesions were biopsied. The primary endpoint was the GN detection rate during primary observation. Secondary endpoints were the rate of missed GNs, early gastric cancer detection rate, and positive predictive value for a GN diagnosis. The decision rule had a higher GN detection rate between 3G-NBI and TXI, outperforming WLI by >1.0%. Results: Finally, 901 patients were enrolled and assigned to the 3G-NBI, TXI, and WLI groups (300, 300, and 301 patients, respectively). GN detection rates in the 3G-NBI, TXI, and WLI groups were 7.3, 5.0, and 5.6%, respectively. The rates of missed GNs were 1.0, 0.7, and 1.0%, the detection rates of early gastric cancer were 5.7, 4.0, and 5.6%, and the positive predictive values for the diagnosis of GN were 36.5, 21.3, and 36.8% in the 3G-NBI, TXI, and WLI groups, respectively. Discussion: Compared with TXI and WLI, 3G-NBI is a more promising modality for GN detection. (Copyright © 2024 by The American College of Gastroenterology.)
Databáze:	MEDLINE
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