Narrow band imaging: Important tool for early diagnosis, management, and improved outcomes in gastrointestinal lesions.

IF 2.3 3区医学 Q2 SURGERY

World Journal of Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI:10.1002/wjs.12348

Afzal Anees, Afreen Ali, Shaan Hassan, Shereen Fatima, Hazique Jameel

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引用次数: 0

Abstract

Background: Narrow band imaging-magnifying endoscopy (NBI-ME) is used to identify changes in mucosal or vascular pattern observed on GI endoscopy in real time on the basis of optical image enhancement.It has a significant role in early detection of dysplasia, premalignant, and Malignant lesions along with its depth of invasion.

Materials and methods: Upper and lower GI endoscopy performed in 1742 patients who presented with gastrointestinal symptoms at this tertiary center over 5 years out of which 1623 were evaluated with both NBI-ME and histopathology. Real time endoscopic assessment was performed. Targeted biopsies were taken for comparative analysis.

Results: Of the 1742 patients, 119 were excluded from the study. 807 underwent upper GI endoscopy and 816 underwent lower GI endoscopy. Mean age of presentation was 38 +/- 2.7 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of NBI-ME for neoplastic esophageal lesions were 96.3%, 90.6%, 91.1%, 96.03%, respectively. For Barrett's esophagus it was 95.4%, 90.7%, 86.1%, and 90.7%; For gastric neoplastic lesions the values were 96.1%, 91.04%, 83.8%, and 97.9%. For colorectal it was 96.7%, 91.3%, 88.0%, and 97.7%. Overall sensitivity, specificity, PPV, and NPV of NBI-ME for neoplastic lesions (both upper and lower GI) were 96.2%, 91.0%, 96.2%, and 97.2%. Of the 1623 patients, 951 received medical management with regular surveillance and 672 patients with high-grade dysplasia, premalignant, and malignant conditions underwent interventions in form of either endoscopy or surgery.

Conclusion: NBI-ME has a greater role and can be considered as an effective tool in making early diagnosis and guiding optimum treatment.

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窄带成像：早期诊断、管理和改善胃肠道病变预后的重要工具。

背景：窄带成像放大内镜（NBI-ME）用于在光学图像增强的基础上实时识别消化道内镜观察到的粘膜或血管形态的变化：材料和方法：5 年来，该三级医疗中心对 1742 名出现胃肠道症状的患者进行了上下消化道内窥镜检查，其中 1623 人接受了 NBI-ME 和组织病理学评估。进行了实时内镜评估。结果：结果：在 1742 名患者中，有 119 人被排除在研究之外。807人接受了上消化道内窥镜检查，816人接受了下消化道内窥镜检查。平均发病年龄为 38 +/- 2.7 岁。NBI-ME对食管肿瘤病变的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为96.3%、90.6%、91.1%和96.03%。巴雷特食管的 NPV 分别为 95.4%、90.7%、86.1% 和 90.7%；胃肿瘤病变的 NPV 分别为 96.1%、91.04%、83.8% 和 97.9%。结肠直肠癌的检测值分别为 96.7%、91.3%、88.0% 和 97.7%。NBI-ME 对肿瘤病变（包括上消化道和下消化道）的总体敏感性、特异性、PPV 和 NPV 分别为 96.2%、91.0%、96.2% 和 97.2%。在1623名患者中，951人接受了定期监测的内科治疗，672名高级别发育不良、恶性肿瘤前期和恶性肿瘤患者接受了内镜检查或手术治疗：NBI-ME在早期诊断和指导最佳治疗方面发挥着更大的作用，可被视为一种有效的工具。

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

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.