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Diagnostic values of dual focus narrow band imaging and probe-based confocal laser endomicroscopy in FAP-related duodenal adenoma.

Pittayanon R, Rerknimitr R, Imraporn B, Wisedopas N, Kullavanijaya P - Endosc Int Open (2015)

Bottom Line: Histology from the matched lesion was used as the gold standard.A total of 55 matched biopsies (25 ampullas, 30 nonampullas) were performed.The sensitivity, specificity, post predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI vs. pCLE from all duodenal lesions were 96.9 % vs. 93.8 %, 78.3 % vs. 81 %, 86.1 % vs. 88.2 %, 94.7 vs. 89.5 %, and 92.4 % vs. 88.6 %, respectively.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital The Thai Red Cross Society, Bangkok, 10330, Thailand.

ABSTRACT

Background and study aims: Familial adenomatous polyposis (FAP) is associated with an increased risk of development of periampullary and nonampullary adenoma. Either routine biopsy or endoscopic removal of the lesion is generally required to identify the presence of adenoma. Because the risk of tissue sampling from the ampulla is high and nonampullary polyps are sometimes numerous, resection of all the lesions is time-consuming. This study aimed to evaluate the diagnostic values of duodenal adenoma by dual focus NBI (dNBI) and probe-based confocal endomicroscopy (pCLE) in FAP patients.

Patients and methods: The authors conducted a diagnostic study in a single tertiary-care referral center. Surveillance esophagogastroduodenoscopy with dNBI and pCLE was performed on 26 patients with FAP for real-time adenoma diagnosis by two different endoscopists; one used dNBI and the other pCLE. Histology from the matched lesion was used as the gold standard.

Results: A total of 55 matched biopsies (25 ampullas, 30 nonampullas) were performed. The sensitivity, specificity, post predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI vs. pCLE from all duodenal lesions were 96.9 % vs. 93.8 %, 78.3 % vs. 81 %, 86.1 % vs. 88.2 %, 94.7 vs. 89.5 %, and 92.4 % vs. 88.6 %, respectively.

Conclusions: For surveillance of periampullary and nonampullary adenoma in patients with FAP, the real-time readings provided a high degree of diagnostic value when histology was used as the gold standard. (

Clinical trial registration number: NCT02162173).

No MeSH data available.


Related in: MedlinePlus

The corresponding adenoma finding from pCLE and pathological image
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FI216-3: The corresponding adenoma finding from pCLE and pathological image

Mentions: In our experience, because of enhancement of the vessels in the lamina propria (seen as deep blue color) with dNBI, we observed better delineation of both villi and vascular patterns. Moreover, the white villi with well-demarcated borders were better appreciated with dNBI. Apart from the better quality of the new NBI, we speculate that the higher efficacy of our NBI readings may be related to the more specific criteria for duodenal adenoma that we used 12. On the other hand, the pCLE images of adenoma that showed dark, irregular, and nonstructural mucosa and sometimes abnormal capillary networks corresponded well to the histology of adenoma, which typically contains elongated, stratified columnar cells with increased nuclear-cytoplasmic ratio, known as “atypical columnar cells” ( Fig. 3).


Diagnostic values of dual focus narrow band imaging and probe-based confocal laser endomicroscopy in FAP-related duodenal adenoma.

Pittayanon R, Rerknimitr R, Imraporn B, Wisedopas N, Kullavanijaya P - Endosc Int Open (2015)

The corresponding adenoma finding from pCLE and pathological image
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4612245&req=5

FI216-3: The corresponding adenoma finding from pCLE and pathological image
Mentions: In our experience, because of enhancement of the vessels in the lamina propria (seen as deep blue color) with dNBI, we observed better delineation of both villi and vascular patterns. Moreover, the white villi with well-demarcated borders were better appreciated with dNBI. Apart from the better quality of the new NBI, we speculate that the higher efficacy of our NBI readings may be related to the more specific criteria for duodenal adenoma that we used 12. On the other hand, the pCLE images of adenoma that showed dark, irregular, and nonstructural mucosa and sometimes abnormal capillary networks corresponded well to the histology of adenoma, which typically contains elongated, stratified columnar cells with increased nuclear-cytoplasmic ratio, known as “atypical columnar cells” ( Fig. 3).

Bottom Line: Histology from the matched lesion was used as the gold standard.A total of 55 matched biopsies (25 ampullas, 30 nonampullas) were performed.The sensitivity, specificity, post predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI vs. pCLE from all duodenal lesions were 96.9 % vs. 93.8 %, 78.3 % vs. 81 %, 86.1 % vs. 88.2 %, 94.7 vs. 89.5 %, and 92.4 % vs. 88.6 %, respectively.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital The Thai Red Cross Society, Bangkok, 10330, Thailand.

ABSTRACT

Background and study aims: Familial adenomatous polyposis (FAP) is associated with an increased risk of development of periampullary and nonampullary adenoma. Either routine biopsy or endoscopic removal of the lesion is generally required to identify the presence of adenoma. Because the risk of tissue sampling from the ampulla is high and nonampullary polyps are sometimes numerous, resection of all the lesions is time-consuming. This study aimed to evaluate the diagnostic values of duodenal adenoma by dual focus NBI (dNBI) and probe-based confocal endomicroscopy (pCLE) in FAP patients.

Patients and methods: The authors conducted a diagnostic study in a single tertiary-care referral center. Surveillance esophagogastroduodenoscopy with dNBI and pCLE was performed on 26 patients with FAP for real-time adenoma diagnosis by two different endoscopists; one used dNBI and the other pCLE. Histology from the matched lesion was used as the gold standard.

Results: A total of 55 matched biopsies (25 ampullas, 30 nonampullas) were performed. The sensitivity, specificity, post predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI vs. pCLE from all duodenal lesions were 96.9 % vs. 93.8 %, 78.3 % vs. 81 %, 86.1 % vs. 88.2 %, 94.7 vs. 89.5 %, and 92.4 % vs. 88.6 %, respectively.

Conclusions: For surveillance of periampullary and nonampullary adenoma in patients with FAP, the real-time readings provided a high degree of diagnostic value when histology was used as the gold standard. (

Clinical trial registration number: NCT02162173).

No MeSH data available.


Related in: MedlinePlus