Narrow-band imaging versus Lugol chromoendoscopy for esophageal squamous cell cancer screening in normal endoscopic practice: randomized controlled trial
| Autor: | Béatrice Guerrier, Pascal Renkes, Sandrine Touzet, Melissa Gruner, B. Prost, Christophe Cellier, Mathieu Pioche, Angélique Denis, Verena Landel, Medhi Kaasis, Dominique Luet, Anne-Laure Tarreirias, Michel Antonietti, E Metivier-Cesbron, Gabriel Rahmi, Morgane Amil, Thierry Ponchon, Serge Fratte, Philippe Balian, Laurent Lefrou, P. Rey, Marc Le Rhun, Elia Samaha, Claude Masliah, Stéphane Lecleire, Jean-Louis Legoux, Emmanuel Coron |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms Sensitivity and Specificity law.invention Chromoendoscopy Narrow Band Imaging Randomized controlled trial law Multicenter trial Carcinoma Humans Medicine Prospective Studies Coloring Agents Prospective cohort study Early Detection of Cancer Squamous cell cancer Narrow-band imaging medicine.diagnostic_test business.industry Gastroenterology Iodides medicine.disease Endoscopy Carcinoma Squamous Cell Esophageal Squamous Cell Carcinoma Esophagoscopy Radiology business |
| Zdroj: | Endoscopy. 53:674-682 |
| ISSN: | 1438-8812 0013-726X |
| Popis: | Background Narrow-band imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect esophageal squamous cell carcinoma (SCC) but its specificity, which appears higher than that of Lugol chromoendoscopy in expert centers, remains to be established in general practice. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy in the detection of esophageal SCC and high grade dysplasia (HGD) in current general practice (including tertiary care centers, local hospitals, and private clinics). Methods This prospective randomized multicenter trial included consecutive patients with previous or current SCC of the upper aerodigestive tract who were scheduled for gastroscopy. Patients were randomly allocated to either the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, NBI examination was performed after white-light endoscopy. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis. Results 334 patients with history of SCC were included and analyzed (intention-to-treat) from 15 French institutions between March 2011 and December 2015. In per-patient analysis, sensitivity, specificity, positive and negative likelihood values were 100 %, 66.0 %, 21.2 %, and 100 %, respectively, for Lugol chromoendoscopy vs. 100 %, 79.9 %, 37.5 %, and 100 %, respectively, for NBI. Specificity was greater with NBI than with Lugol (P = 0.002). Conclusions As previously demonstrated in expert centers, NBI was more specific than Lugol in current gastroenterology practice for the detection of early SCC, but combined approaches with both NBI and Lugol could improve the detection of squamous neoplasia. |
| Databáze: | OpenAIRE |
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