Department of Endoscopy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Banshan Road 1, Gongshu District, Hangzhou, 310022, Zhejiang, China.
Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, 310022, Zhejiang, China.
Surg Endosc. 2024 Nov;38(11):6541-6550. doi: 10.1007/s00464-024-11235-6. Epub 2024 Sep 13.
The Pink Zone Pattern (PP) sign is a typical color alteration of early gastric cancer (EGC) under magnifying endoscopic narrow-band imaging (ME-NBI). By integrating the color changes (PP sign) with the "vessel plus surface (VS)" classification system, we developed an innovative diagnostic system for EGC and named it "Pink Microsurface Microvascular (PSV)" system. Here, we aimed to elucidate the diagnostic performance of the PSV system for EGC.
We conducted a single-center prospective clinical study (before-after design) consisting of 2 cross-sectional studies at 2 separate periods. In the before phase, 184 suspected lesions were evaluated using the VS system under ME-NBI; in the after phase, 183 suspected lesions were evaluated using the PSV system. We compared the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) between the VS group and the PSV group.
The accuracy, sensitivity, specificity, PPV, and NPV of the VS system for EGC were 84.6%, 87.0%, 83.6%, 67.8%, and 94.2%, respectively, and those for the PSV system were 93.0%, 92.0%, 93.4%, 85.2%, and 96.6%, respectively. The accuracy, specificity, and PPV of the PSV system were superior to those of the VS system. However, the sensitivity and NPV did not significantly differ between the VS system and the PSV system. The VS system was inconclusive for 22 lesions (12.0%) and the PSV system was inconclusive for 11 lesions (6.0%). The PSV system could identify more suspicious lesions than the VS system.
We propose a new PSV diagnostic system by combining the VS system and the PP sign. Compared with the VS system, the PSV system could identify more suspected lesions and improve the diagnostic performance of EGC.
在放大内镜窄带成像（ME-NBI）下，粉红色区域模式（PP）是早期胃癌（EGC）的典型颜色改变。通过整合颜色变化（PP 征象）和“血管加表面（VS）”分类系统，我们开发了一种新的 EGC 诊断系统，并将其命名为“粉红色微表面微血管（PSV）”系统。在此，我们旨在阐明 PSV 系统对 EGC 的诊断性能。
我们进行了一项单中心前瞻性临床研究（前后设计），包括 2 个在两个不同时期的横断面研究。在前期，184 个可疑病变在 ME-NBI 下用 VS 系统进行评估；在后期，183 个可疑病变用 PSV 系统进行评估。我们比较了 VS 组和 PSV 组的诊断准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
VS 系统对 EGC 的准确性、敏感性、特异性、PPV 和 NPV 分别为 84.6%、87.0%、83.6%、67.8%和 94.2%，PSV 系统分别为 93.0%、92.0%、93.4%、85.2%和 96.6%。PSV 系统的准确性、特异性和 PPV 优于 VS 系统。然而，VS 系统和 PSV 系统之间的敏感性和 NPV 没有显著差异。VS 系统对 22 个病变（12.0%）的诊断不确定，PSV 系统对 11 个病变（6.0%）的诊断不确定。PSV 系统比 VS 系统能识别更多可疑病变。
我们提出了一种新的 PSV 诊断系统，将 VS 系统和 PP 征象结合起来。与 VS 系统相比，PSV 系统可以识别更多可疑病变，提高 EGC 的诊断性能。
