Cargando…
Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors
Background and study aims Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2019
|
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811346/ https://www.ncbi.nlm.nih.gov/pubmed/31673625 http://dx.doi.org/10.1055/a-0999-5282 |
_version_ | 1783462459532640256 |
---|---|
author | Tahara, Tomomitsu Horiguchi, Noriyuki Terada, Tsuyoshi Yamada, Hyuga Yoshida, Dai Okubo, Masaaki Funasaka, Kohei Nagasaka, Mitsuo Nakagawa, Yoshihito Tsukamoto, Tetsuya Shibata, Tomoyuki Kuroda, Makoto Ohmiya, Naoki |
author_facet | Tahara, Tomomitsu Horiguchi, Noriyuki Terada, Tsuyoshi Yamada, Hyuga Yoshida, Dai Okubo, Masaaki Funasaka, Kohei Nagasaka, Mitsuo Nakagawa, Yoshihito Tsukamoto, Tetsuya Shibata, Tomoyuki Kuroda, Makoto Ohmiya, Naoki |
author_sort | Tahara, Tomomitsu |
collection | PubMed |
description | Background and study aims Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings. Patients and methods pCLE scanning of 20 SNADET lesions including 16 adenomas and four carcinomas was retrospectively evaluated to explore abnormal pCLE findings in relation to histological features. Diagnostic yield of pCLE findings was prospectively evaluated in an additional 20 SNADET lesions including 16 adenomas and four carcinomas. Results In a retrospective study, we identified four abnormal pCLE findings of SNADETs: (1) dark epithelium, (2) columnar cells irregularly extending to the lumen, (3) distorted crypt structure, and (4) fluorescein leakage. Dark epithelium distinguished neoplastic lesions (adenomas and carcinomas) from non-neoplastic duodenal mucosa with a sensitivity of 90 % and a specificity of 100 %. Distorted crypt structure distinguished carcinomas from adenomas and non-neoplastic duodenal mucosa with a sensitivity of 100% and a specificity of 94 %. In the prospective study, the sensitivity and the specificity of the dark epithelium for the diagnosis of neoplastic lesions (adenomas + carcinomas) was 75% and 100 %. Sensitivity and the specificity of the distorted crypt structure for discrimination of carcinoma from adenoma were 100 % and 94 %, respectively. Conclusions The pCLE findings correlated with the histopathology of the SNADETs. Dark epithelium and distorted crypt structure were informative pCLE findings to predict presence of neoplasia and cancer in the SNADET, respectively. UMIN-CTR UMIN000013857 TRIAL REGISTRATION: Single-Center, prospective observational trial UMIN000013857 at upload.umin.ac.jp |
format | Online Article Text |
id | pubmed-6811346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-68113462019-11-01 Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors Tahara, Tomomitsu Horiguchi, Noriyuki Terada, Tsuyoshi Yamada, Hyuga Yoshida, Dai Okubo, Masaaki Funasaka, Kohei Nagasaka, Mitsuo Nakagawa, Yoshihito Tsukamoto, Tetsuya Shibata, Tomoyuki Kuroda, Makoto Ohmiya, Naoki Endosc Int Open Background and study aims Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings. Patients and methods pCLE scanning of 20 SNADET lesions including 16 adenomas and four carcinomas was retrospectively evaluated to explore abnormal pCLE findings in relation to histological features. Diagnostic yield of pCLE findings was prospectively evaluated in an additional 20 SNADET lesions including 16 adenomas and four carcinomas. Results In a retrospective study, we identified four abnormal pCLE findings of SNADETs: (1) dark epithelium, (2) columnar cells irregularly extending to the lumen, (3) distorted crypt structure, and (4) fluorescein leakage. Dark epithelium distinguished neoplastic lesions (adenomas and carcinomas) from non-neoplastic duodenal mucosa with a sensitivity of 90 % and a specificity of 100 %. Distorted crypt structure distinguished carcinomas from adenomas and non-neoplastic duodenal mucosa with a sensitivity of 100% and a specificity of 94 %. In the prospective study, the sensitivity and the specificity of the dark epithelium for the diagnosis of neoplastic lesions (adenomas + carcinomas) was 75% and 100 %. Sensitivity and the specificity of the distorted crypt structure for discrimination of carcinoma from adenoma were 100 % and 94 %, respectively. Conclusions The pCLE findings correlated with the histopathology of the SNADETs. Dark epithelium and distorted crypt structure were informative pCLE findings to predict presence of neoplasia and cancer in the SNADET, respectively. UMIN-CTR UMIN000013857 TRIAL REGISTRATION: Single-Center, prospective observational trial UMIN000013857 at upload.umin.ac.jp © Georg Thieme Verlag KG 2019-11 2019-10-23 /pmc/articles/PMC6811346/ /pubmed/31673625 http://dx.doi.org/10.1055/a-0999-5282 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Tahara, Tomomitsu Horiguchi, Noriyuki Terada, Tsuyoshi Yamada, Hyuga Yoshida, Dai Okubo, Masaaki Funasaka, Kohei Nagasaka, Mitsuo Nakagawa, Yoshihito Tsukamoto, Tetsuya Shibata, Tomoyuki Kuroda, Makoto Ohmiya, Naoki Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title | Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title_full | Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title_fullStr | Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title_full_unstemmed | Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title_short | Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
title_sort | diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811346/ https://www.ncbi.nlm.nih.gov/pubmed/31673625 http://dx.doi.org/10.1055/a-0999-5282 |
work_keys_str_mv | AT taharatomomitsu diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT horiguchinoriyuki diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT teradatsuyoshi diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT yamadahyuga diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT yoshidadai diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT okubomasaaki diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT funasakakohei diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT nagasakamitsuo diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT nakagawayoshihito diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT tsukamototetsuya diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT shibatatomoyuki diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT kurodamakoto diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors AT ohmiyanaoki diagnosticutilityofprobebasedconfocallaserendomicroscopyinsuperficialnonampullaryduodenalepithelialtumors |