Yield of Neoplasia by Confocal Laser Endomicroscopy in the Chronic Atrophic Gastritis

Aims. The aims of this study were to characterize nonatrophic and atrophic gastric mucosa under conventional endoscopy and probe-based confocal laser endomicroscopy (pCLE) modes and to define quantitative diagnostic parameters for these lesions under pCLE. Method. In phase I, 64 patients with gastric mucosal lesions diagnosed by gastrointestinal endoscopy were enrolled in the study. Normal mucosa and suspicious lesions were evaluated under normal white light imaging (WLI) and pCLE mode. Descriptive characteristic of gastric mucosal inflammation and atrophy under pCLE were defined according to the histology. In phase II, the criteria for nonatrophic gastritis (NAG) and chronic atrophic gastritis (CAG) under pCLE were used to diagnose the mucosal lesions in 431 patients. Diagnostic accuracy of each endoscopy modes was evaluated by measuring the concordance with histology. Result. A total of 64 patients with 187 positions were enrolled in the first part of this study. According to the histological diagnosis, the vessel diameter was increased in the NAG (11.18 ± 0.1 μm) and CAG (13.21 ± 0.29 μm) groups compared to the normal group (10.58 ± 0.13 μm); meanwhile, the distance between glands was 17.75 ± 0.51 μm in the normal group, 22.38 ± 0.45 μm in the NAG group, and 34.66 ± 0.82 μm in the CAG group, which increased significantly compared to nonatrophic mucosa. In order to differentiate atrophic mucosa from nonatrophic mucosa in real time, the cutoff value between these two kinds of lesions was >30 μm in distance between glands. In phase II, 431 patients with 431 positions were evaluated under pCLE by using the criteria above. The sensitivity, specificity, PPV, and NPV for the diagnostic parameter were 90.3%, 78.8%, 85.1%, and 85.8%. The consistency of pCLE (Kappa value = 0.698) with histology was much better than WLI (Kappa value = 0.393). Conclusion. pCLE shows high potential for the diagnosis of gastric inflammation and atrophy based on quantitative criteria and has the ability to be a substitute for histology in the diagnosis of diffuse lesions in the stomach.

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Mo1554 Grading Atrophic Gastritis by a New Quantitative Method Using Confocal LASER Endomicroscopy Probe (P-CLE): First Results of a Prospective Cohort Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.1670 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB464

Author(s):

Carlos Robles-Medranda ◽

Miguel Puga-Tejada ◽

Jesenia Ospina ◽

Miguel Soria Alcívar ◽

Gladys Bravo Velez ◽

...

Keyword(s):

Cohort Study ◽

Atrophic Gastritis ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Quantitative Method ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

First Results

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The Accuracy of Confocal Laser Endomicroscopy, Narrow Band Imaging, and Chromoendoscopy for the Detection of Atrophic Gastritis

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0000000000000164 ◽

2015 ◽

Vol 49 (5) ◽

pp. 379-386 ◽

Cited By ~ 15

Author(s):

Tao Liu ◽

Haoxuan Zheng ◽

Wei Gong ◽

Chudi Chen ◽

Bo Jiang

Keyword(s):

Atrophic Gastritis ◽

Narrow Band ◽

Narrow Band Imaging ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser

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Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

10.21203/rs.3.rs-133839/v1 ◽

2021 ◽

Author(s):

Suya Pang ◽

Huiying Shi ◽

Hailing Yao ◽

Chen Jiang ◽

Qin Zhang ◽

...

Keyword(s):

Atrophic Gastritis ◽

White Light ◽

Severity Score ◽

Chronic Atrophic Gastritis ◽

Confocal Laser ◽

Targeted Biopsy ◽

Image Diagnosis ◽

Diagnosis Rate ◽

Sensitivity Specificity ◽

Targeted Biopsies

Abstract Background: Chronic atrophic gastritis (CAG) are closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser microscopy (CLE) in CAG missed under WLE biopsy remains unclear.Methods: This study is a single-center prospective study that included 21 patients who were diagnosed with CAG under WLE, and whose pathological results were chronic inflammation. Then, all these patients received a CLE examination and endoscopic features were evaluated. All patients underwent targeted biopsies and five-point standard biopsies under CLE. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed by using the five-point standard biopsy pathological results.Results: The pathological results of five-point standard biopsies in 21 patients were CAG, and 17 patients (81.0%) were intestinal metaplasia (IM). According to the image diagnosis under CLE, 19 of these 21 patients (90.5%) were diagnosed with CAG, and 14 of them (66.7%) were diagnosed with IM. According to the targeted biopsy under CLE, 17 (81.0%) patients were diagnosed with CAG, and 14 of them (66.7%) were diagnosed with IM. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p=0.927), IM severity score (p=0.250), atrophy scope score (p=0.781) and IM scope score (p=0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p=0.331). For IM, the sensitivity, specificity and accuracy of CLE image diagnosis were the same as those of CLE targeted biopsies.Conclusions: CLE can improve the diagnosis rate of CAG, and can increase the comprehensive assessment of the scope and severity of CAG.

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