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Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis.
Clin Res Hepatol Gastroenterol 2018; 42(1):31-39CR

Abstract

AIMS

Barrett's esophagus (BE) predisposes to the development of esophageal neoplasia, including high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). A systematic literature review and meta-analysis were performed to assess the accuracy of within-patient comparisons of narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) for diagnosis of HGD/EAC in patients with BE.

METHODS

The following databases were examined up to April 2016 without language restriction: PubMed, Embase, Medline, Web of Science and the Cochrane Library. The QUADAS-2 tool for assessing the quality of included studies was used. The meta-analysis included pooled additional detection rate (ADR), diagnostic accuracy, and 95% confidence intervals (CI). The I2 and Q-test were used to determine study heterogeneity.

RESULTS

Five studies involving 251 patients, reported within-patient comparisons of NBI and CLE, were eligible for meta-analysis. Compared with NBI, pooled ADR of CLE for per-lesion detection of neoplasia in patients with BE was 19.3% (95% CI: 0.05-0.33, I2=74.6%). The pooled sensitivity of NBI was 62.8% (95% CI: 0.56-0.69, I2=94.6%), which was lower (not significantly) than that of CLE (72.3%, 95% CI: 0.66-0.78, I2=89.3%). The pooled specificity of NBI and CLE were similar [85.3% (95% CI: 0.84-0.87, I2=92.1%) vs 83.8% (95% CI: 0.82-0.85, I2=96.8%)].

CONCLUSIONS

When compared with NBI, CLE significantly increased the per-lesion detection rate of esophageal neoplasia, HGD, and EAC in BE patients. Whether CLE is superior to NBI in neoplasia detection at per-patient level needs to be further investigated.

Authors+Show Affiliations

Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, 1838 Guangzhou North Road, 510515 Guangzhou, China.School of Public Health, Central South University, Changsha, 410008 Hunan, China.Medical College, University of South China, 421000 Hengyang, China.Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, 1838 Guangzhou North Road, 510515 Guangzhou, China.Department of Biostatistics, School of Public Health, Southern Medical University, 1838 Guangzhou North Road, 510515 Guangzhou, China.Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, 1838 Guangzhou North Road, 510515 Guangzhou, China.Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, 1838 Guangzhou North Road, 510515 Guangzhou, China.Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, 1838 Guangzhou North Road, 510515 Guangzhou, China. Electronic address: qch.2009@163.com.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

29277482

Citation

Xiong, Yi-Quan, et al. "Comparison of Narrow-band Imaging and Confocal Laser Endomicroscopy for the Detection of Neoplasia in Barrett's Esophagus: a Meta-analysis." Clinics and Research in Hepatology and Gastroenterology, vol. 42, no. 1, 2018, pp. 31-39.
Xiong YQ, Ma SJ, Hu HY, et al. Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis. Clin Res Hepatol Gastroenterol. 2018;42(1):31-39.
Xiong, Y. Q., Ma, S. J., Hu, H. Y., Ge, J., Zhou, L. Z., Huo, S. T., ... Chen, Q. (2018). Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis. Clinics and Research in Hepatology and Gastroenterology, 42(1), pp. 31-39. doi:10.1016/j.clinre.2017.05.005.
Xiong YQ, et al. Comparison of Narrow-band Imaging and Confocal Laser Endomicroscopy for the Detection of Neoplasia in Barrett's Esophagus: a Meta-analysis. Clin Res Hepatol Gastroenterol. 2018;42(1):31-39. PubMed PMID: 29277482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of narrow-band imaging and confocal laser endomicroscopy for the detection of neoplasia in Barrett's esophagus: A meta-analysis. AU - Xiong,Yi-Quan, AU - Ma,Shu-Juan, AU - Hu,Hao-Yue, AU - Ge,Jing, AU - Zhou,Li-Zhi, AU - Huo,Shu-Ting, AU - Qiu,Min, AU - Chen,Qing, Y1 - 2017/12/23/ PY - 2016/11/16/received PY - 2017/04/19/revised PY - 2017/05/12/accepted PY - 2017/12/27/pubmed PY - 2019/5/29/medline PY - 2017/12/27/entrez KW - Barrett's esophagus KW - Confocal laser endomicroscopy KW - Meta-analysis KW - Narrow band imaging KW - Neoplasia SP - 31 EP - 39 JF - Clinics and research in hepatology and gastroenterology JO - Clin Res Hepatol Gastroenterol VL - 42 IS - 1 N2 - AIMS: Barrett's esophagus (BE) predisposes to the development of esophageal neoplasia, including high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). A systematic literature review and meta-analysis were performed to assess the accuracy of within-patient comparisons of narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) for diagnosis of HGD/EAC in patients with BE. METHODS: The following databases were examined up to April 2016 without language restriction: PubMed, Embase, Medline, Web of Science and the Cochrane Library. The QUADAS-2 tool for assessing the quality of included studies was used. The meta-analysis included pooled additional detection rate (ADR), diagnostic accuracy, and 95% confidence intervals (CI). The I2 and Q-test were used to determine study heterogeneity. RESULTS: Five studies involving 251 patients, reported within-patient comparisons of NBI and CLE, were eligible for meta-analysis. Compared with NBI, pooled ADR of CLE for per-lesion detection of neoplasia in patients with BE was 19.3% (95% CI: 0.05-0.33, I2=74.6%). The pooled sensitivity of NBI was 62.8% (95% CI: 0.56-0.69, I2=94.6%), which was lower (not significantly) than that of CLE (72.3%, 95% CI: 0.66-0.78, I2=89.3%). The pooled specificity of NBI and CLE were similar [85.3% (95% CI: 0.84-0.87, I2=92.1%) vs 83.8% (95% CI: 0.82-0.85, I2=96.8%)]. CONCLUSIONS: When compared with NBI, CLE significantly increased the per-lesion detection rate of esophageal neoplasia, HGD, and EAC in BE patients. Whether CLE is superior to NBI in neoplasia detection at per-patient level needs to be further investigated. SN - 2210-741X UR - https://www.unboundmedicine.com/medline/citation/29277482/Comparison_of_narrow_band_imaging_and_confocal_laser_endomicroscopy_for_the_detection_of_neoplasia_in_Barrett's_esophagus:_A_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-7401(17)30136-5 DB - PRIME DP - Unbound Medicine ER -