Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma

Kengo Nagai, Ryu Ishihara, Shingo Ishiguro, Takashi Ohta, Hiromitsu Kanzaki, Takeshi Yamashina, Kenji Aoi, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Sachiko Yamamoto, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Hiroyasu Iishi, Masaharu Tatsuta, Yasuhiko Tomita, Takashi Matsunaga

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Recent technological advances have stimulated the development of endoscopic optical biopsy technologies. This study compared the accuracy of endoscopic diagnosis using magnifying narrow-band imaging (NBI) and histologic diagnosis of esophageal squamous lesions.Methods: Patients at high risk for esophageal squamous cell carcinoma were examined with endoscopy and subsequent biopsy. The lesions diagnosed as cancer on NBI and the lesions diagnosed as cancer on biopsy were resected endoscopically or surgically. Histological diagnoses of resected specimens, the reference standards in this study, were made by a pathologist who was blind to both the endoscopic and biopsy diagnoses. The primary outcome was the accuracy of endoscopic and biopsy diagnosis. A noninferiority trial design with a noninferiority margin of -10% was chosen to investigate the accuracy of endoscopic diagnosis using magnifying NBI.Results: Between November 2010 and October 2012, a total of 111 lesions in 85 patients were included in the analysis. The accuracy of endoscopic diagnosis and biopsy diagnosis for all lesions was 91.0% (101/111) and 85.6% (95/111), respectively. The difference in diagnostic accuracy was 5.4% (95% confidence interval: -2.9%-13.7%). The accuracy of endoscopic diagnosis and biopsy diagnosis of invasive cancers was 94.9% (74/78) and 84.6% (66/78), respectively. The difference was 10.3% (95% confidence interval: 1.6%-19.0%) for invasive cancers. The lower bound of the 95% confidence interval was above the prestated -10% in both cases.Conclusion: Noninferiority of endoscopic diagnosis by magnifying NBI to histologic diagnosis by biopsy was established in this study (p = 0.0001).

Original languageEnglish
Article number141
JournalBMC Gastroenterology
Volume14
Issue number1
DOIs
Publication statusPublished - Aug 9 2014

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Narrow Band Imaging
Biopsy
Confidence Intervals
Esophageal Squamous Cell Carcinoma
Neoplasms
Endoscopy
Technology

Keywords

  • Endoscopic diagnosis
  • Esophageal cancer
  • Esophageal neoplasms
  • Narrow-band imaging
  • Optical biopsy

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma. / Nagai, Kengo; Ishihara, Ryu; Ishiguro, Shingo; Ohta, Takashi; Kanzaki, Hiromitsu; Yamashina, Takeshi; Aoi, Kenji; Matsuura, Noriko; Ito, Takashi; Fujii, Mototsugu; Yamamoto, Sachiko; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Uedo, Noriya; Iishi, Hiroyasu; Tatsuta, Masaharu; Tomita, Yasuhiko; Matsunaga, Takashi.

In: BMC Gastroenterology, Vol. 14, No. 1, 141, 09.08.2014.

Research output: Contribution to journalArticle

Nagai, K, Ishihara, R, Ishiguro, S, Ohta, T, Kanzaki, H, Yamashina, T, Aoi, K, Matsuura, N, Ito, T, Fujii, M, Yamamoto, S, Hanaoka, N, Takeuchi, Y, Higashino, K, Uedo, N, Iishi, H, Tatsuta, M, Tomita, Y & Matsunaga, T 2014, 'Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma', BMC Gastroenterology, vol. 14, no. 1, 141. https://doi.org/10.1186/1471-230X-14-141
Nagai, Kengo ; Ishihara, Ryu ; Ishiguro, Shingo ; Ohta, Takashi ; Kanzaki, Hiromitsu ; Yamashina, Takeshi ; Aoi, Kenji ; Matsuura, Noriko ; Ito, Takashi ; Fujii, Mototsugu ; Yamamoto, Sachiko ; Hanaoka, Noboru ; Takeuchi, Yoji ; Higashino, Koji ; Uedo, Noriya ; Iishi, Hiroyasu ; Tatsuta, Masaharu ; Tomita, Yasuhiko ; Matsunaga, Takashi. / Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma. In: BMC Gastroenterology. 2014 ; Vol. 14, No. 1.
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AU - Nagai, Kengo

AU - Ishihara, Ryu

AU - Ishiguro, Shingo

AU - Ohta, Takashi

AU - Kanzaki, Hiromitsu

AU - Yamashina, Takeshi

AU - Aoi, Kenji

AU - Matsuura, Noriko

AU - Ito, Takashi

AU - Fujii, Mototsugu

AU - Yamamoto, Sachiko

AU - Hanaoka, Noboru

AU - Takeuchi, Yoji

AU - Higashino, Koji

AU - Uedo, Noriya

AU - Iishi, Hiroyasu

AU - Tatsuta, Masaharu

AU - Tomita, Yasuhiko

AU - Matsunaga, Takashi

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N2 - Background: Recent technological advances have stimulated the development of endoscopic optical biopsy technologies. This study compared the accuracy of endoscopic diagnosis using magnifying narrow-band imaging (NBI) and histologic diagnosis of esophageal squamous lesions.Methods: Patients at high risk for esophageal squamous cell carcinoma were examined with endoscopy and subsequent biopsy. The lesions diagnosed as cancer on NBI and the lesions diagnosed as cancer on biopsy were resected endoscopically or surgically. Histological diagnoses of resected specimens, the reference standards in this study, were made by a pathologist who was blind to both the endoscopic and biopsy diagnoses. The primary outcome was the accuracy of endoscopic and biopsy diagnosis. A noninferiority trial design with a noninferiority margin of -10% was chosen to investigate the accuracy of endoscopic diagnosis using magnifying NBI.Results: Between November 2010 and October 2012, a total of 111 lesions in 85 patients were included in the analysis. The accuracy of endoscopic diagnosis and biopsy diagnosis for all lesions was 91.0% (101/111) and 85.6% (95/111), respectively. The difference in diagnostic accuracy was 5.4% (95% confidence interval: -2.9%-13.7%). The accuracy of endoscopic diagnosis and biopsy diagnosis of invasive cancers was 94.9% (74/78) and 84.6% (66/78), respectively. The difference was 10.3% (95% confidence interval: 1.6%-19.0%) for invasive cancers. The lower bound of the 95% confidence interval was above the prestated -10% in both cases.Conclusion: Noninferiority of endoscopic diagnosis by magnifying NBI to histologic diagnosis by biopsy was established in this study (p = 0.0001).

AB - Background: Recent technological advances have stimulated the development of endoscopic optical biopsy technologies. This study compared the accuracy of endoscopic diagnosis using magnifying narrow-band imaging (NBI) and histologic diagnosis of esophageal squamous lesions.Methods: Patients at high risk for esophageal squamous cell carcinoma were examined with endoscopy and subsequent biopsy. The lesions diagnosed as cancer on NBI and the lesions diagnosed as cancer on biopsy were resected endoscopically or surgically. Histological diagnoses of resected specimens, the reference standards in this study, were made by a pathologist who was blind to both the endoscopic and biopsy diagnoses. The primary outcome was the accuracy of endoscopic and biopsy diagnosis. A noninferiority trial design with a noninferiority margin of -10% was chosen to investigate the accuracy of endoscopic diagnosis using magnifying NBI.Results: Between November 2010 and October 2012, a total of 111 lesions in 85 patients were included in the analysis. The accuracy of endoscopic diagnosis and biopsy diagnosis for all lesions was 91.0% (101/111) and 85.6% (95/111), respectively. The difference in diagnostic accuracy was 5.4% (95% confidence interval: -2.9%-13.7%). The accuracy of endoscopic diagnosis and biopsy diagnosis of invasive cancers was 94.9% (74/78) and 84.6% (66/78), respectively. The difference was 10.3% (95% confidence interval: 1.6%-19.0%) for invasive cancers. The lower bound of the 95% confidence interval was above the prestated -10% in both cases.Conclusion: Noninferiority of endoscopic diagnosis by magnifying NBI to histologic diagnosis by biopsy was established in this study (p = 0.0001).

KW - Endoscopic diagnosis

KW - Esophageal cancer

KW - Esophageal neoplasms

KW - Narrow-band imaging

KW - Optical biopsy

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