Third-generation autofluorescence endoscopy for the detection of early neoplasia in Barrett's esophagus: a pilot study

被引：16
作者：
Boerwinkel, D. F. [1 ]
Holz, J. A. [2 ]
Aalders, M. C. G. [2 ]
Visser, M. [3 ]
Meijer, S. L. [3 ]
Henegouwen, M. I. Van Berge [4 ]
Weusten, B. L. A. M. [1 ,5 ]
Bergman, J. J. G. H. M. [1 ]
机构：
[1] Univ Amsterdam, Acad Med Ctr, Dept Gastroenterol & Hepatol, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Biomed Engn & Phys, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Pathol, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1105 AZ Amsterdam, Netherlands
[5] St Antonius Hosp, Dept Gastroenterol & Hepatol, Nieuwegein, Netherlands
来源：
DISEASES OF THE ESOPHAGUS | 2014年 / 27卷 / 03期
关键词：
autofluorescence imaging; Barrett's esophagus; endoscopy; narrow-band imaging; neoplasia; HIGH-GRADE DYSPLASIA; MUCOSAL MORPHOLOGY; CLASSIFICATION; SYSTEM; VIDEO; ADENOCARCINOMA; SPECTROSCOPY; SURVEILLANCE; VALIDATION; DIAGNOSIS;
D O I：
10.1111/dote.12094
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
In Barrett's esophagus (BE), second-generation autofluorescence imaging (AFI-II) improves targeted detection of high-grade intra-epithelial neoplasia (HGIN) and early cancer (EC), yet suffers from high false-positive (FP) rates. The newest generation AFI (AFI-III) specifically targets fluorescence in malignant cells and may therefore improve detection of early neoplasia and reduce FP rate. The aim was to compare AFI-III with AFI-II for endoscopic detection of early neoplasia in BE. BE patients with endoscopically inconspicuous neoplasia underwent two diagnostic endoscopies (AFI-II/AFI-III) in a single session. End-points: number of patients and lesions with HGIN/EC detected with AFI-II and AFI-III after white-light endoscopy (WLE) and the value of reinspection of AFI-positive areas with WLE and narrow-band imaging. Forty-five patients were included (38 males, age 65 years). Nineteen patients showed HGIN/EC. AFI-II inspection after WLE increased detection of HGIN/EC from 9 to 15 patients (47 to 79%); AFI-III increased detection from 9 to 17 patients (47 to 89%). WLE plus random biopsies diagnosed 13/19 (68%) HGIN/EC patients. One hundred and four abnormal AFI areas were inspected; 23 (22%) showed HGIN/EC. AFI-II increased detection of HGIN/EC from 10 to 18 lesions (43 to 78%). AFI-III increased detection from 10 to 20 lesions (43-87%). FP rate was 86% for AFI-II and AFI-III. Reinspection with WLE or narrow-band imaging reduced FP rate to 21% and 22%, respectively, but misclassified HGIN/EC lesions as unsuspicious in 54% and 31%, respectively. This first feasibility study on third-generation AFI again showed improved targeted detection of HGIN/EC in BE. However, the results do not suggest AFI-III performs significantly better than conventional AFI-II.
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收藏
页码：276 / 284
页数：9
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