Endoscopic detection and diagnosis of gastric cancer using image‐enhanced endoscopy: A systematic review and meta‐analysis

Author:

Dohi Osamu1ORCID,Seya Mayuko1,Iwai Naoto1,Ochiai Tomoko1,Yumoto Junki1,Mukai Hiroki1,Yamauchi Katsuma1,Kobayashi Reo1,Hirose Ryohei12,Inoue Ken1,Yoshida Naohisa1ORCID,Konishi Hideyuki1,Itoh Yoshito1

Affiliation:

1. Molecular Gastroenterology and Hepatology Graduate School of Medicine, Kyoto Prefectural University of Medicine Kyoto Japan

2. Department of Infectious Diseases Graduate School of Medical Science, Kyoto, Prefectural University of Medicine Kyoto Japan

Abstract

AbstractObjectivesWe aimed to conduct a systematic review and meta‐analysis to assess the value of image‐enhanced endoscopy including blue laser imaging (BLI), linked color imaging, narrow‐band imaging (NBI), and texture and color enhancement imaging to detect and diagnose gastric cancer (GC) compared to that of white‐light imaging (WLI).MethodsStudies meeting the inclusion criteria were identified through PubMed, Cochrane Library, and Japan Medical Abstracts Society databases searches. The pooled risk ratio for dichotomous variables was calculated using the random‐effects model to assess the GC detection between WLI and image‐enhanced endoscopy. A random‐effects model was used to calculate the overall diagnostic performance of WLI and magnifying image‐enhanced endoscopy for GC.ResultsSixteen studies met the inclusion criteria. The detection rate of GC was significantly improved in linked color imaging compared with that in WLI (risk ratio, 2.20; 95% confidence interval [CI], 1.39–3.25; p < 0.01) with mild heterogeneity. Magnifying endoscopy with NBI (ME‐NBI) obtained a pooled sensitivity, specificity, and area under the summary receiver operating curve of 0.84 (95 % CI, 0.80–0.88), 0.96 (95 % CI, 0.94–0.97), and 0.92, respectively. Similarly, ME‐BLI showed a pooled sensitivity, specificity, and area under the curve of 0.81 (95 % CI, 0.77–0.85), 0.85 (95 % CI, 0.82–0.88), and 0.95, respectively. The diagnostic efficacy of ME‐NBI/BLI for GC was evidently high compared to that of WLI, However, significant heterogeneity among the NBI studies still existed.ConclusionsOur meta‐analysis showed a high detection rate for linked color imaging and a high diagnostic performance of ME‐NBI/BLI for GC compared to that with WLI.

Publisher

Wiley

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