NARROW-BAND IMAGING (NBI) VERSUS LUGOL CHROMOENDOSCOPY IN THE DETECTION OF OESOPHAGUS SQUAMOUS NEOPLASMS IN A HIGH-RISK POPULATION: A REAL-LIFE RANDOMISED CONTROLLED MULTICENTRE TRIAL

M Gruner; A Denis; C Masliah; M Amil; E Metivier-Cesbron; D Luet; M Kaasis; E Coron; M Le Rhun; S Lecleire; M Antonietti; JL Legoux; L Lefrou; P Renkes; AL Tarreirrias; P Balian; P Rey; B Prost; C Cellier; G Rahmi; S Elia; S Fratte; B Guerrier; S Touzet; T Ponchon; M Pioche

doi:10.1055/s-0038-1637184

Endoscopy, Table of Contents

Endoscopy 2018; 50(04): S52-S53
DOI: 10.1055/s-0038-1637184

ESGE Days 2018 oral presentations

20.04.2018 – Best abstract awards

Georg Thieme Verlag KG Stuttgart · New York

NARROW-BAND IMAGING (NBI) VERSUS LUGOL CHROMOENDOSCOPY IN THE DETECTION OF OESOPHAGUS SQUAMOUS NEOPLASMS IN A HIGH-RISK POPULATION: A REAL-LIFE RANDOMISED CONTROLLED MULTICENTRE TRIAL

Authors

M Gruner

¹Edouard Herriot Hospital, Lyon, France
A Denis

²Hospices Civils de Lyon, Pôle IMER, Lyon, France
C Masliah

³Clinique Mutualiste de l'Estuaire, Saint Nazaire, France
M Amil

⁴Centre Hospitalier les Oudairies, La Roche sur Lyon, France
E Metivier-Cesbron

⁵Centre Hospitalo-Universitaire d'Angers, Site Larrey, Angers, France
D Luet

⁵Centre Hospitalo-Universitaire d'Angers, Site Larrey, Angers, France
M Kaasis

⁶Centre Hospitalier de Cholet, Cholet, France
E Coron

⁷Hotel Dieu, Hepatogastroenterology Department, Nantes, France
M Le Rhun

⁷Hotel Dieu, Hepatogastroenterology Department, Nantes, France
S Lecleire

⁸Charles Nicolle Hospital, Rouen, France
M Antonietti

⁸Charles Nicolle Hospital, Rouen, France
JL Legoux

⁹La Source Hospital, Orléans, France
L Lefrou

⁹La Source Hospital, Orléans, France
P Renkes

¹⁰Clinique Claude Bernard Hospital, Metz, France
AL Tarreirrias

¹¹Foch Hospital, Suresnes, France
P Balian

¹¹Foch Hospital, Suresnes, France
P Rey

¹²Hopital d'Instruction des Armées, Legouest, Metz, France
B Prost

¹³Saint Joseph, Saint Luc Hospital, Lyon, France
C Cellier

¹⁴Hopital Européen Georges Pompidou, Paris, France
G Rahmi

¹⁴Hopital Européen Georges Pompidou, Paris, France
S Elia

¹⁴Hopital Européen Georges Pompidou, Paris, France
S Fratte

¹⁵Centre Hospitalier de Belfort, Belfort, France
B Guerrier

¹⁶Centre Hospitalier de Bourg-en-Bresse, Bourg-en-Bresse, France
S Touzet

²Hospices Civils de Lyon, Pôle IMER, Lyon, France
T Ponchon

¹Edouard Herriot Hospital, Lyon, France

¹⁷Lyon 1 University Claude Bernard, Lyon, France

¹⁸INSERM U1032, LabTAU, Lyon, France
M Pioche

¹⁷Lyon 1 University Claude Bernard, Lyon, France

¹⁸INSERM U1032, LabTAU, Lyon, France

¹⁹Hopital Edouard Herriot, Lyon, France

Abstract

Full Text

Aims:

Narrow-Band Imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect oesophageal squamous cell carcinoma (SCC) and appears more specific than Lugol chromoendoscopy in expert centres but its specificity in current practice is not known. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy to detect oesophageal SCC and high-grade dysplasia (HGD) in current practice (including tertiary care centres, local hospitals and private clinics).

Methods:

We conducted a prospective randomized multicentre trial including all patients, addressed for a gastroscopy, with previous or current SCC of the upper aerodigestive tract. Patients included were randomly allocated either to the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, a NBI examination was added between white light and Lugol chromoendoscopy. In both groups, the gastroscopy was realised by a single operator performing the successive examinations without blinding. Once detected, all lesions were biopsied to confirm or to reject the histology diagnosis of SCC or dysplasia. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis.

Results:

Among the 335 patients included in 14 French institutions from March 2011 to December 2015, 315 were analysed (Lugol group n = 159, NBI group n = 156). In a per-patient analysis, sensitivity, specificity, positive and negative likelihood values were respectively 100%, 79.1%, 37%, and 100% for NBI vs. 100%, 61.1%, 23.9%, and 100% for Lugol chromoendoscopy. The NBI specificity was significantly greater than that of Lugol chromoendoscopy (p < 0.001).

Conclusions:

We show here the superiority of NBI specificity over Lugol chromoendoscopy to detect oesophageal SCC and HGD in current gastroenterology practice.