The diagnostic utility of endocytoscopy for the detection of gastric cancer: a systematic review and meta-analysis.

Introduction: Endocytoscopy (ECS) is an evolving technology that utilizes ultra-high power magnification for real time cellular imaging without the need for physical biopsy. Its application for gastric cancer (GC) detection is not well evaluated at the current time, but there is potential that ECS can make a real time histopathological diagnosis to differentiate neoplastic from benign lesions. We aimed to investigate the diagnostic utility of ECS for GC detection.

Evidence acquisition: Literature searches through multiple databases were performed for studies using ECS for GC detection until November 2021. Measured outcomes included the pooled sensitivity, specificity and accuracy. Quality assessment of diagnostic studies tool was used to assess the risk of bias.

Evidence synthesis: Four studies (N.=245) were included. The pooled sensitivity was 83.5% (95% CI: 75-89%, I²: 0) and specificity was 91.7% (95% CI: 79-97%, I²: 58%). The pooled accuracy was 89.2% (95% CI: 83-94%, I²: 38%). There was a low risk of bias.

Conclusions: ECS is an accurate diagnostic modality and has the potential to serve as a complimentary tool in screening for GC. Larger prospective studies are needed to validate these findings before its further widespread use.