Zhang Qiang, Wang Fei, Chen Zhen-Yu, Wang Zhen, Zhi Fa-Chao, Liu Si-De, Bai Yang
Department of Gastroenterology, Nanfang Hospital, Southen Medical University, Guangzhou, Guangdong, China.
Gastric Cancer. 2016 Apr;19(2):543-552. doi: 10.1007/s10120-015-0500-5. Epub 2015 Apr 29.
Magnifying endoscopy with narrow band imaging (ME-NBI) is widely used in gastroscopy, especially in the diagnosis of early gastric cancer. The purpose of this meta-analysis is to compare the diagnostic efficacy of white light imaging (WLI) and that of ME-NBI for early gastric cancer.
PubMed/MEDLINE, EMBASE, and the Cochrane Library were searched to identify studies which met the inclusion criteria. A random-effects model was used to calculate overall sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) to assess the diagnostic efficacy of WLI and ME-NBI in early gastric cancer. Sensitivity analysis was performed to assess the stability of the results.
Ten studies met the inclusion criteria, and included 1724 patients and 2153 lesions. The pooled sensitivity, specificity, and AUC for the diagnosis of early gastric cancer using WLI were 0.48 [95 % confidence interval (CI) 0.39-0.57; I (2) = 78.6 %], 0.67 (95 % CI 0.62-0.71; I (2) = 81.9 %), and 0.62, respectively. The pooled sensitivity, specificity, and AUC using ME-NBI were 0.83 (95 % CI 0.79-0.87; I (2) = 79.8 %), 0.96 (95 % CI 0.95-0.97; I (2) = 89.3 %), and 0.96, respectively. The studies showed a high degree of heterogeneity. Further sensitivity analysis was mainly performed for the studies of small lesions (mean size 10 mm or less) and the studies with a the score of 12 points or greater in the literature quality assessment, and the AUCs for ME-NBI for diagnosis of early gastric cancer were between 0.93 and 0.98, which suggested that the diagnostic value was still high and stable.
Compared with WLI, ME-NBI can effectively diagnose early gastric cancer.
窄带成像放大内镜（ME-NBI）在胃镜检查中广泛应用，尤其用于早期胃癌的诊断。本荟萃分析旨在比较白光成像（WLI）和ME-NBI对早期胃癌的诊断效能。
检索PubMed/MEDLINE、EMBASE和Cochrane图书馆，以识别符合纳入标准的研究。采用随机效应模型计算总体敏感性、特异性和受试者工作特征曲线下面积（AUC），以评估WLI和ME-NBI对早期胃癌的诊断效能。进行敏感性分析以评估结果的稳定性。
10项研究符合纳入标准，共纳入1724例患者和2153个病变。使用WLI诊断早期胃癌的合并敏感性、特异性和AUC分别为0.48[95%置信区间（CI）0.39 - 0.57；I² = 78.6%]、0.67（95%CI 0.62 - 0.71；I² = 81.9%）和0.62。使用ME-NBI的合并敏感性、特异性和AUC分别为0.83（95%CI 0.79 - 0.87；I² = 79.8%）、0.96（95%CI 0.95 - 0.97；I² = 89.3%）和0.96。这些研究显示出高度的异质性。进一步的敏感性分析主要针对小病变（平均大小10mm或更小）的研究以及文献质量评估得分12分或更高的研究，ME-NBI诊断早期胃癌的AUC在0.93至0.98之间，这表明诊断价值仍然较高且稳定。
与WLI相比，ME-NBI能有效诊断早期胃癌。
