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Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients

BACKGROUND: Upper gastrointestinal malignancies are a major global health burden. Early diagnosis of upper gastrointestinal premalignant and malignant lesions is crucial for improving prognosis and reducing morbidity and mortality. The purpose of this study was to investigate the diagnostic accuracy...

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Autores principales: Seerani, Nand Lal, Laghari, Hira, Khidri, Feriha Fatima, Sawai, Sajan, Bajwa, Akram, Devi, Jalpa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: West Asia Organization for Cancer Prevention 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505884/
https://www.ncbi.nlm.nih.gov/pubmed/37378923
http://dx.doi.org/10.31557/APJCP.2023.24.6.1949
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author Seerani, Nand Lal
Laghari, Hira
Khidri, Feriha Fatima
Sawai, Sajan
Bajwa, Akram
Devi, Jalpa
author_facet Seerani, Nand Lal
Laghari, Hira
Khidri, Feriha Fatima
Sawai, Sajan
Bajwa, Akram
Devi, Jalpa
author_sort Seerani, Nand Lal
collection PubMed
description BACKGROUND: Upper gastrointestinal malignancies are a major global health burden. Early diagnosis of upper gastrointestinal premalignant and malignant lesions is crucial for improving prognosis and reducing morbidity and mortality. The purpose of this study was to investigate the diagnostic accuracy of confocal laser endomicroscopy (CLE) in detecting upper gastrointestinal premalignant and early malignant lesions in high-risk patients, as well as diagnosing patients with inconclusive white light endoscopy (WLE) and histopathology results. METHODS: It was a cross-sectional study that included ninety (n = 90) high-risk patients with inconclusive diagnoses of upper gastrointestinal lesions on WLE and WLE-based biopsy histopathology. These patients underwent CLE, and the definitive diagnosis was confirmed using CLE and CLE-target biopsy histopathology. Diagnostic accuracy was determined by comparing the sensitivity, specificity, predictive values, and accuracy between the procedures. RESULT: The mean patient age was 47.43 ± 11.18 years. CLE and target biopsy confirmed that 30 (33.3%) patients had normal histology, while 60 (66.7%) patients were diagnosed with gastritis, gastric intestinal metaplasia, high-grade dysplasia, adenocarcinoma, Barrett’s esophagus, and squamous cell carcinoma of the esophagus. The results of CLE were superior to those of WLE in terms of diagnostic parameters. Additionally, CLE demonstrated nearly similar results in sensitivity (98.33%), specificity (100%), positive predictive value (100%), negative predictive value (96.77%), and accuracy (98.89%) when compared to CLE-target biopsy. CONCLUSION: CLE showed higher diagnostic accuracy in differentiating normal, premalignant and malignant lesions. It effectively diagnosed patients who initially had inconclusive WLE and/or biopsy results. Furthermore, early detection of upper gastrointestinal premalignant or malignant lesions may improve prognosis and reduce morbidity and mortality.
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spelling pubmed-105058842023-09-19 Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients Seerani, Nand Lal Laghari, Hira Khidri, Feriha Fatima Sawai, Sajan Bajwa, Akram Devi, Jalpa Asian Pac J Cancer Prev Research Article BACKGROUND: Upper gastrointestinal malignancies are a major global health burden. Early diagnosis of upper gastrointestinal premalignant and malignant lesions is crucial for improving prognosis and reducing morbidity and mortality. The purpose of this study was to investigate the diagnostic accuracy of confocal laser endomicroscopy (CLE) in detecting upper gastrointestinal premalignant and early malignant lesions in high-risk patients, as well as diagnosing patients with inconclusive white light endoscopy (WLE) and histopathology results. METHODS: It was a cross-sectional study that included ninety (n = 90) high-risk patients with inconclusive diagnoses of upper gastrointestinal lesions on WLE and WLE-based biopsy histopathology. These patients underwent CLE, and the definitive diagnosis was confirmed using CLE and CLE-target biopsy histopathology. Diagnostic accuracy was determined by comparing the sensitivity, specificity, predictive values, and accuracy between the procedures. RESULT: The mean patient age was 47.43 ± 11.18 years. CLE and target biopsy confirmed that 30 (33.3%) patients had normal histology, while 60 (66.7%) patients were diagnosed with gastritis, gastric intestinal metaplasia, high-grade dysplasia, adenocarcinoma, Barrett’s esophagus, and squamous cell carcinoma of the esophagus. The results of CLE were superior to those of WLE in terms of diagnostic parameters. Additionally, CLE demonstrated nearly similar results in sensitivity (98.33%), specificity (100%), positive predictive value (100%), negative predictive value (96.77%), and accuracy (98.89%) when compared to CLE-target biopsy. CONCLUSION: CLE showed higher diagnostic accuracy in differentiating normal, premalignant and malignant lesions. It effectively diagnosed patients who initially had inconclusive WLE and/or biopsy results. Furthermore, early detection of upper gastrointestinal premalignant or malignant lesions may improve prognosis and reduce morbidity and mortality. West Asia Organization for Cancer Prevention 2023 /pmc/articles/PMC10505884/ /pubmed/37378923 http://dx.doi.org/10.31557/APJCP.2023.24.6.1949 Text en https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Research Article
Seerani, Nand Lal
Laghari, Hira
Khidri, Feriha Fatima
Sawai, Sajan
Bajwa, Akram
Devi, Jalpa
Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title_full Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title_fullStr Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title_full_unstemmed Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title_short Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients
title_sort role of confocal laser endomicroscopy in early detection of upper gastrointestinal malignancy in high risk patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505884/
https://www.ncbi.nlm.nih.gov/pubmed/37378923
http://dx.doi.org/10.31557/APJCP.2023.24.6.1949
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