East J E, Tan E K, Bergman J J, Saunders B P, Tekkis P P
Wolfson Unit for Endoscopy, St. Mark's Hospital, Imperial College London, London.
Aliment Pharmacol Ther. 2008 Oct 1;28(7):854-67. doi: 10.1111/j.1365-2036.2008.03802.x. Epub 2008 Jul 10.
Narrow band imaging is a new endoscopic technology that highlights mucosal surface structures and microcapillaries, which may be indicative of neoplastic change.
To assess the diagnostic precision of narrow band imaging for the diagnosis of epithelial neoplasia compared to conventional histology both overall and in specific organs.
We performed a meta-analysis of studies which compared narow band imaging-based diagnosis of neoplasia with histopathology as the gold standard. Search terms: 'endoscopy' and 'narrow band imaging'.
Five hundred and eighty-two patients and 1108 lesions in 11 studies were included. Overall, sensitivity was 0.94 (95% confidence interval 0.92-0.95), specificity 0.83 (0.80-0.86); weighted area under the curve was 0.96 (standard error 0.02), diagnostic odds ratio (DOR) 72.74 (34.11-155.15). DORs were 66.65 (25.84-171.90), 61.19 (7.09-527.97), 69.74 (8.04-605.24) for colon, oesophagus and lung respectively. Studies with more than 50 patients had higher diagnostic precision, relative DOR 4.96 (1.28-19.27), P = 0.022. There was no difference in accuracy between microvessel and mucosal (pit) pattern based measures, relative DOR 1.29 (0.05-35.16), P = 0.87. There was significant heterogeneity overall between studies, Q = 31.2, P = 0.003.
Narrow band imaging is accurate with high diagnostic precision for in vivo diagnosis of neoplasia across a range of organs, using simple microvessel-based measures.
窄带成像技术是一种新型内镜技术，可突出显示黏膜表面结构和微血管，这可能提示肿瘤性改变。
评估窄带成像诊断上皮性肿瘤的诊断准确性，并与传统组织学方法在整体及特定器官中的诊断准确性进行比较。
我们对以组织病理学为金标准，比较基于窄带成像诊断肿瘤的研究进行了荟萃分析。检索词：“内镜检查”和“窄带成像”。
纳入11项研究中的582例患者及1108个病变。总体而言，敏感性为0.94（95%置信区间0.92 - 0.95），特异性为0.83（0.80 - 0.86）；曲线下加权面积为0.96（标准误0.02），诊断比值比（DOR）为72.74（34.11 - 155.15）。结肠、食管和肺的DOR分别为66.65（25.84 - 171.90）、61.19（7.09 - 527.97）、69.74（8.04 - 605.24）。患者超过50例的研究诊断准确性更高，相对DOR为4.96（1.28 - 19.27），P = 0.022。基于微血管和黏膜（凹陷）模式的测量方法在准确性上无差异，相对DOR为1.29（0.05 - 35.16），P = 0.87。研究间总体存在显著异质性，Q = 31.2，P = 0.003。
窄带成像技术利用基于简单微血管的测量方法，对一系列器官的肿瘤进行体内诊断准确且诊断精度高。
