Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis

Autor: Qing Chen, Hao-Yue Hu, Min Qiu, Shu-ting Huo, Jing Ge, Shu-Juan Ma, Li-Zhi Zhou, Yi-Quan Xiong
Rok vydání: 2016
Předmět:
Zdroj: Clinics and research in hepatology and gastroenterology. 42(1)
ISSN: 2210-741X
Popis: Summary Aims Barrett's esophagus (BE) predisposes to the development of esophageal neoplasia, including high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). A systematic literature review and meta-analysis were performed to assess the accuracy of within-patient comparisons of narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) for diagnosis of HGD/EAC in patients with BE. Methods The following databases were examined up to April 2016 without language restriction: PubMed, Embase, Medline, Web of Science and the Cochrane Library. The QUADAS-2 tool for assessing the quality of included studies was used. The meta-analysis included pooled additional detection rate (ADR), diagnostic accuracy, and 95% confidence intervals (CI). The I2 and Q-test were used to determine study heterogeneity. Results Five studies involving 251 patients, reported within-patient comparisons of NBI and CLE, were eligible for meta-analysis. Compared with NBI, pooled ADR of CLE for per-lesion detection of neoplasia in patients with BE was 19.3% (95% CI: 0.05–0.33, I2 = 74.6%). The pooled sensitivity of NBI was 62.8% (95% CI: 0.56–0.69, I2 = 94.6%), which was lower (not significantly) than that of CLE (72.3%, 95% CI: 0.66–0.78, I2 = 89.3%). The pooled specificity of NBI and CLE were similar [85.3% (95% CI: 0.84–0.87, I2 = 92.1%) vs 83.8% (95% CI: 0.82–0.85, I2 = 96.8%)]. Conclusions When compared with NBI, CLE significantly increased the per-lesion detection rate of esophageal neoplasia, HGD, and EAC in BE patients. Whether CLE is superior to NBI in neoplasia detection at per-patient level needs to be further investigated.
Databáze: OpenAIRE
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