Duan Hui, Zhou Xinxu, Li Qian, Liu Liu, Wang Qiong, Wu Kaiwen, Jiang Lin, Sun Xiaobin
The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.
Front Oncol. 2024 Nov 15;14:1480651. doi: 10.3389/fonc.2024.1480651. eCollection 2024.
Conventional white light imaging (WLI) frequently misses gastric cancer, resulting in a high rate of undiagnosed cases. This study compares the effectiveness of linked color imaging (LCI) and WLI in detecting early gastric cancer and gastrointestinal metaplasia, aiming to improve clinical diagnostic practices through evidence-based medical insights.
The QUADAS-2 tool evaluated the quality of the studies. Additionally, methods like Split Component Synthesis (SCS) were utilized to evaluate the diagnostic performance of LCI and WLI.
Eleven studies involving a total of 7836 patients were included in the meta-analysis. Comparative analysis revealed that LCI demonstrated a statistically significant superiority over WLI in terms of the detection rates of EGC and GIM (detection rate of EGC: LCI vs WLI, 85% vs. 56.7%, p=0.004, OR 4.78, 95% CI 2.33-9.82, I2 = 71%; detection rate of GIM: LCI vs WLI, 88.9% vs. 40.1%, p=0.0003, OR 9.94, 95% CI 5.59-17.68, I2 = 71%). Additionally, LCI exhibited better sensitivity and specificity for the diagnosis of EGC and GIM compared to WLI. For the entire cohort, the sensitivity of LCI for EGC detection was 80% (95% CI 71%-86%) with a specificity of 82% (95% CI 63%-92%), while for GIM detection, the sensitivity was 87% (95% CI 81%-92%) with a specificity of 85% (95% CI 77%-91%).
The detection efficiency of LCI for EGC and GIM is better than that of WLI, and LCI is recommended as the main screening method for EGC and GIM.
https://www.crd.york.ac.uk/prospero/, identifier CRD42023452140.
传统白光成像（WLI）经常漏诊胃癌，导致未确诊病例率很高。本研究比较了联动成像（LCI）和WLI在检测早期胃癌和胃肠化生方面的有效性，旨在通过循证医学见解改善临床诊断实践。
使用QUADAS-2工具评估研究质量。此外，采用了诸如拆分组件合成（SCS）等方法来评估LCI和WLI的诊断性能。
荟萃分析纳入了11项研究，共7836例患者。对比分析显示，在早期胃癌（EGC）和胃肠化生（GIM）的检出率方面，LCI在统计学上显著优于WLI（EGC检出率：LCI vs WLI，85% vs. 56.7%，p = 0.004，OR 4.78，95% CI 2.33 - 9.82，I² = 71%；GIM检出率：LCI vs WLI，88.9% vs. 40.1%，p = 0.0003，OR 9.94，95% CI 5.59 - 17.68，I² = 71%）。此外，与WLI相比，LCI在EGC和GIM诊断方面表现出更好的敏感性和特异性。对于整个队列，LCI检测EGC的敏感性为80%（95% CI 71% - 86%），特异性为82%（95% CI 63% - 92%），而检测GIM时，敏感性为87%（95% CI 81% - 92%），特异性为85%（95% CI 77% - 91%）。
LCI对EGC和GIM的检测效率优于WLI，建议将LCI作为EGC和GIM的主要筛查方法。
