scholarly journals Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

2020 ◽  
Author(s):  
Lihua Chu ◽  
Jialian Zhao ◽  
Cheng Sheng ◽  
Min Yue ◽  
Feifei Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Retrospective Cohort ◽  
Precancerous Lesions ◽  
Characteristic Curve ◽  
Intraepithelial Neoplasia ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Validity And Reliability ◽  
Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into the propofol-based sedated group (n=126) and the un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0% in the sedated group and 27.59% in the un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

scholarly journals Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnosing accuracy: a retrospective cohort study in China

2020 ◽  
Author(s):  
Lihua Chu ◽  
Jialian Zhao ◽  
Cheng Sheng ◽  
Min Yue ◽  
Feifei Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Retrospective Cohort ◽  
Precancerous Lesions ◽  
Characteristic Curve ◽  
Intraepithelial Neoplasia ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Validity And Reliability ◽  
Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into propofol-based sedated group (n=126) and un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnose and pathological diagnose. Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive ESD subsequently, and the misdiagnosis rate of CLE was 0 in sedated group and 27.59% in un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

scholarly journals Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lihua Chu ◽  
Jialian Zhao ◽  
Cheng Sheng ◽  
Min Yue ◽  
Feifei Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Retrospective Cohort ◽  
Precancerous Lesions ◽  
Characteristic Curve ◽  
Intraepithelial Neoplasia ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Patient Cooperation

Abstract Background Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions. Methods A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n = 126) and the un-sedated group (n = 100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines. Results The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95 % CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95 % CI: 0.80 to 0.97), P = 0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P = 0.0008 and P = 0.0001, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0 % in the sedated group and 27.59 % (95 % CI: 10.30–44.91 %) in the un-sedated group (P = 0.006). Conclusions Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

scholarly journals Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

2020 ◽  
Author(s):  
Lihua Chu ◽  
Jialian Zhao ◽  
Cheng Sheng ◽  
Min Yue ◽  
Feifei Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Retrospective Cohort ◽  
Precancerous Lesions ◽  
Characteristic Curve ◽  
Intraepithelial Neoplasia ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n=126) and the un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0001, respectively). Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

Endoscopic molecular imaging of early gastric cancer targeting transferrin receptor 1.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e23093-e23093
Author(s):  
Jie Tian ◽  
Yang Du
Keyword(s):  
Gastric Cancer ◽  
Molecular Imaging ◽  
Early Gastric Cancer ◽  
Diagnostic Accuracy ◽  
Transferrin Receptor ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Human Gastric Cancer ◽  
Transferrin Receptor 1

e23093 Background: Gastric cancer is primarily managed endoscopically by white light gastroscope with suboptimal diagnostic accuracy. Emerging optical imaging technologies possess great potential for improving diagnostic accuracy but currently lack imaging agents for molecular specificity. In this study, a novel ligand of transferrin receptor 1 (TfR1), human H-ferritin (HFn), was labeled with fluorescent agents to enable in vivo real-time imaging by confocal laser endomicroscopy (CLE). Methods: In vivo fluorescence imaging was performed in tumor-bearing mice from human gastric cancer cell lines using fluorescently labeled HFn nanoprobe. The HFn-FITC as molecular imaging agent was applied to the gastric cancer with confocal laser endomicroscopy (CLE) in fresh endoscopic submucosal dissection (ESD) of early gastric cancer. Results: Intravital imaging of gastric xenograft tumors revealed a specific tumor targeting effects of HFn-IRDye800CW, whereas no specific signal was observed in mice injected with free dye. An ex vivo experiment on human specimens using a rigid confocal probe showed positive fluorescent staining in ESD samples diagnosed as early gastric cancers. Our CLE evaluation correlated well with immunohistochemical findings. Conclusions: CLE can be used for in vivo, molecular analysis of early gastric cancer and to identify TfR1 expression in xenografts and human tissue samples. HFn-targeted molecular imaging could improve early detection of gastric cancer.

scholarly journals Expression of Oncostatin M in Early Gastric Cancer and Precancerous Lesions

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jihua Shi ◽  
Xue Xu ◽  
Jun Du ◽  
Haimeng Cui ◽  
Qingfeng Luo
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Chronic Gastritis ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Oncostatin M ◽  
Low Grade ◽  
Mucosal Epithelium ◽  
Expression Levels ◽  
Significant Difference

Objective. To detect the expression of the Oncostatin M (OSM) gene and encoded protein in the mucosal epithelium of chronic gastritis, intestinal metaplasia (IM), low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), early gastric cancer (EGC), and advanced gastric cancer (AGC) samples and to explore the correlation and clinicopathological significance of OSM expression in the process of gastric carcinogenesis. Methods. The expression levels of OSM in chronic gastritis, IM, LGIN, HGIN, EGC, and AGC samples were detected by gene chip, real-time quantitative PCR, and immunohistochemical methods. The expression levels of OSM in the gastric mucosa were analyzed, and its correlation with clinical pathology was studied. Results. The expression level of OSM in gastric HGIN and EGC tissues was significantly higher than that in LGIN tissues based on expression profiling (P<0.001). The expression of the OSM gene in EGC was higher than that in HGIN (unpaired t test, P<0.05) and LGIN (unpaired t test, P<0.01) by qPCR. The expression of OSM in LGIN was significantly lower than that in HGIN (P=0.008) and EGC (P=0.044) by immunohistochemical staining. The expression of OSM in HGIN tissues was significantly higher than that in AGC (P=0.007). Conclusion. Alterations in the expression of the OSM gene may be involved in the malignant transformation of the gastric mucosal epithelium. Because of the significant difference in the cancerization rate and clinical management between LGIN and HGIN, the difference in the staining intensity of OSM between LGIN and HGIN may be one of the early markers of gastric intraepithelial neoplasia.

scholarly journals A novel combination of serum microRNAs for the detection of early gastric cancer

2021 ◽  
Author(s):  
Seiichiro Abe ◽  
Juntaro Matsuzaki ◽  
Kazuki Sudo ◽  
Ichiro Oda ◽  
Hitoshi Katai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Expression Profiles ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Cancer Center ◽  
Serum Samples ◽  
Retrospective Case ◽  
Serum Mirnas ◽  
Validation Set

Abstract Background The aim of this study was to identify serum miRNAs that discriminate early gastric cancer (EGC) samples from non-cancer controls using a large cohort. Methods This retrospective case–control study included 1417 serum samples from patients with EGC (seen at the National Cancer Center Hospital in Tokyo between 2008 and 2012) and 1417 age- and gender-matched non-cancer controls. The samples were randomly assigned to discovery and validation sets and the miRNA expression profiles of whole serum samples were comprehensively evaluated using a highly sensitive DNA chip (3D-Gene®) designed to detect 2565 miRNA sequences. Diagnostic models were constructed using the levels of several miRNAs in the discovery set, and the diagnostic performance of the model was evaluated in the validation set. Results The discovery set consisted of 708 samples from EGC patients and 709 samples from non-cancer controls, and the validation set consisted of 709 samples from EGC patients and 708 samples from non-cancer controls. The diagnostic EGC index was constructed using four miRNAs (miR-4257, miR-6785-5p, miR-187-5p, and miR-5739). In the discovery set, a receiver operating characteristic curve analysis of the EGC index revealed that the area under the curve (AUC) was 0.996 with a sensitivity of 0.983 and a specificity of 0.977. In the validation set, the AUC for the EGC index was 0.998 with a sensitivity of 0.996 and a specificity of 0.953. Conclusions A novel combination of four serum miRNAs could be a useful non-invasive diagnostic biomarker to detect EGC with high accuracy. A multicenter prospective study is ongoing to confirm the present observations.

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