Efficacy of magnifying endoscopy combined with narrowband imaging in detection of early gastric cancer: a systematic evaluation and meta-analysis.

OBJECTIVE

To systematically evaluate the diagnostic accuracy of magnifying endoscopy combined with narrowband imaging (ME-NBI) in detecting early gastric cancer (EGC) and to provide a scientific basis for its clinical utility.

METHODS

Literature published before May 2024 that utilized ME-NBI for diagnosing EGC was searched across PubMed, EMBASE, The Cochrane Library, Web of Science, and major Chinese databases. Included studies were cohort studies or randomized controlled trials, and their quality was assessed using the QUADAS-2 framework. Meta-analysis was conducted using Stata 17 software to calculate diagnostic indicators such as sensitivity, specificity, and area under the curve (AUC). Heterogeneity was explored through Spearman's correlation coefficient, I statistics, subgroup analysis, and meta-regression analysis. Publication bias was assessed with Deeks' funnel plot.

RESULTS

Twenty studies involving 7,770 patients and 7,917 lesions were included. The pooled sensitivity of ME-NBI for diagnosing EGC was 0.86 (95% CI: 0.80-0.90), specificity was 0.92 (95% CI: 0.86-0.96), and the AUC was 0.94 (95% CI: 0.91-0.96), demonstrating high diagnostic accuracy. Subgroup analysis revealed lower sensitivity in multicenter studies. Excised samples had similar sensitivity to biopsy samples but differed in specificity. Publication bias was detected (P=0.01), but sensitivity analysis corrected for this, maintaining high combined sensitivity, specificity, and AUC.

CONCLUSION

ME-NBI is a highly accurate and reliable diagnostic tool for EGC. Despite have some bias and heterogeneity, this was effectively addressed through sensitivity and subgroup analyses. ME-NBI should be considered a preferred method for EGC screening and diagnosis in clinical practice.