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DOI: 10.1055/s-0038-1637184
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
Publikationsverlauf
Publikationsdatum:
27. März 2018 (online)
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.
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