Feasibility and efficacy of endoscopy with blue laser imaging for the detection and diagnosis of cardia polyps: A single-center randomized controlled study

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases Pub Date : 2024-05-02 DOI:10.1111/1751-2980.13267

Jia Wei Chen, Gang Liu, Yan Fang Lin, Ting You, Li Jia Yao, Bao Shan Wang, Qing Hua Wang, Da Zhou Li, Wen Wang

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Abstract

Objective

To compare the detection rate and diagnostic accuracy of cardia polyps using endoscopy with blue laser imaging (BLI) and white-light imaging (WLI).

Methods

Patients were randomly divided into the BLI group and WLI group according to the endoscopic procedures. BLI followed by WLI was conducted in the BLI group, whereas WLI followed by BLI examination was conducted in the WLI group. The number, size, microstructure, and microvascular patterns of cardia polyps detected were recorded. Biopsy of the polyps was then performed.

Results

The detection rate of cardia polyps in the BLI group was higher than that in the WLI group (7.87% vs 4.22%, P = 0.018). The rate of overlooked lesions in the BLI group was lower than in the WLI group (0.64% vs 3.38%, P = 0.003). The diagnostic coincidence rate between magnifying BLI and histopathology was 88.16%. The sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of neoplastic lesions by magnifying endoscopy with BLI were 90.91%, 87.69%, 55.56%, and 98.28%, respectively. The most remarkable patterns for predicting inflammatory polyps were the prolonged and fine network patterns (sensitivity 71.43%, specificity 93.75%). Small round combined with honeycomb patterns were the most common among fundic gland polyps (sensitivity 80.00%, specificity 98.48%). Neoplastic lesions presented as villous or ridge-like combined with core vascular or unclear pattern for both microvascular and microstructure patterns.

Conclusion

BLI is more effective than WLI in the detection and diagnosis of cardia polyps, and magnifying endoscopy with BLI may help diagnose such lesions.

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内镜结合蓝色激光成像检测和诊断贲门息肉的可行性和有效性：单中心随机对照研究

目的比较内镜下蓝色激光成像（BLI）和白光成像（WLI）对贲门息肉的检出率和诊断准确性。方法根据内镜检查方法将患者随机分为 BLI 组和 WLI 组。BLI 组先进行 BLI 后进行 WLI，而 WLI 组先进行 WLI 后进行 BLI 检查。对检测到的贲门息肉的数量、大小、微观结构和微血管形态进行记录。然后对息肉进行活检。结果 BLI 组的贲门息肉检出率高于 WLI 组（7.87% 对 4.22%，P = 0.018）。BLI组被忽视的病变率低于WLI组（0.64% vs 3.38%，P = 0.003）。放大 BLI 与组织病理学的诊断吻合率为 88.16%。放大 BLI 内镜诊断肿瘤病变的敏感性、特异性、阳性预测值和阴性预测值分别为 90.91%、87.69%、55.56% 和 98.28%。在预测炎性息肉方面，最显著的模式是延长和精细网络模式（灵敏度为 71.43%，特异度为 93.75%）。眼底腺息肉中最常见的是小圆形和蜂窝状形态（敏感性 80.00%，特异性 98.48%）。肿瘤病变表现为绒毛状或脊状合并核心血管，或微血管和微结构形态不清晰。结论在检测和诊断贲门息肉方面，BLI 比 WLI 更有效，BLI 的放大内镜检查可能有助于诊断此类病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Digestive Diseases 医学-胃肠肝病学

CiteScore

5.40

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.