Tada Kazuhiro, Oda Ichiro, Yokoi Chizu, Taniguchi Tomoyasu, Sakamoto Taku, Suzuki Haruhisa, Nonaka Satoru, Yoshinaga Shigetaka, Saito Yutaka, Gotoda Takuji
Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Diagn Ther Endosc. 2011;2011:419136. doi: 10.1155/2011/419136. Epub 2011 Jul 21.
This study aimed to assess and compare effectiveness of Autofluorescence imaging (AFI) in diagnosis of early gastric cancer (EGC) between experienced and less experienced endoscopists. Fifty selected images (20 neoplastic lesions and 30 benign lesions/areas) of both white light endoscopy (WLE) and AFI were blindly reviewed by two groups; first consisted of five experienced endoscopists and second included five less experienced endoscopists. Sensitivity, specificity, and accuracy were 70%, 78%, and 75%, respectively, for AFI and 81%, 76%, and 78%, respectively, for WLE in the experienced group. In the less experienced group, sensitivity, specificity and accuracy were 80%, 81% and 80%, respectively, for AFI and 65%, 77%, and 72%, respectively, for WLE. Interobserver variability for the less experienced group was better with AFI than WLE. AFI improved sensitivity of endoscopic diagnosis of neoplastic lesions by less experienced endoscopists, and its use could beneficially enhance the clinical effectiveness of EGC screening.
本研究旨在评估和比较经验丰富和经验较少的内镜医师使用自体荧光成像(AFI)诊断早期胃癌(EGC)的有效性。两组人员对白光内镜检查(WLE)和AFI的50张选定图像(20个肿瘤性病变和30个良性病变/区域)进行了盲法评估;第一组由五名经验丰富的内镜医师组成,第二组包括五名经验较少的内镜医师。在经验丰富的组中,AFI的敏感性、特异性和准确性分别为70%、78%和75%,WLE的分别为81%、76%和78%。在经验较少的组中,AFI的敏感性、特异性和准确性分别为80%、81%和80%,WLE的分别为65%、77%和72%。经验较少的组中,AFI的观察者间变异性比WLE更好。AFI提高了经验较少的内镜医师对肿瘤性病变的内镜诊断敏感性,其应用可有益地提高EGC筛查的临床效果。