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dc.contributor.authorProtano, Marion-Anna
Xu, Hong
Wang, Guiqi
Polydorides, Alexandros D.
Dawsey, Sanford M.
Cui, Junsheng
Xue, Liyan
Zhang, Fan
Quang, Timothy
Pierce, Mark C.
Shin, Dongsuk
Schwarz, Richard A.
Bhutani, Manoop S.
Lee, Michelle
Parikh, Neil
Hur, Chin
Xu, Weiran
Moshier, Erin
Godbold, James
Mitcham, Josephine
Hudson, Courtney
Richards-Kortum, Rebecca R.
Anandasabapathy, Sharmila
dc.date.accessioned 2017-06-05T21:25:24Z
dc.date.available 2017-06-05T21:25:24Z
dc.date.issued 2015
dc.identifier.citation Protano, Marion-Anna, Xu, Hong, Wang, Guiqi, et al.. "Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial." Gastroenterology, 149, no. 2 (2015) Elsevier: 321-329. https://doi.org/10.1053/j.gastro.2015.04.055.
dc.identifier.urihttps://hdl.handle.net/1911/94811
dc.description.abstract Background & Aims: Esophageal squamous cell neoplasia has a high mortality rate as a result of late detection. In high-risk regions such as China, screening is performed by Lugol’s chromoendoscopy (LCE). LCE has low specificity, resulting in unnecessary tissue biopsy with a subsequent increase in procedure cost and risk. The purpose of this study was to evaluate the accuracy of a novel, low-cost, high-resolution microendoscope (HRME) as an adjunct to LCE. Methods: In this prospective trial, 147 consecutive high-risk patients were enrolled from 2 US and 2 Chinese tertiary centers. Three expert and 4 novice endoscopists performed white-light endoscopy followed by LCE and HRME. All optical images were compared with the gold standard of histopathology. Results: By using a per-biopsy analysis, the sensitivity of LCE vs LCE + HRME was 96% vs 91% (P = .0832), specificity was 48% vs 88% (P < .001), positive predictive value was 22% vs 45% (P < .0001), negative predictive value was 98% vs 98% (P = .3551), and overall accuracy was 57% vs 90% (P < .001), respectively. By using a per-patient analysis, the sensitivity of LCE vs LCE + HRME was 100% vs 95% (P = .16), specificity was 29% vs 79% (P < .001), positive predictive value was 32% vs 60%, 100% vs 98%, and accuracy was 47% vs 83% (P < .001). With the use of HRME, 136 biopsies (60%; 95% confidence interval, 53%–66%) could have been spared, and 55 patients (48%; 95% confidence interval, 38%–57%) could have been spared any biopsy. Conclusions: In this trial, HRME improved the accuracy of LCE for esophageal squamous cell neoplasia screening and surveillance. HRME may be a cost-effective optical biopsy adjunct to LCE, potentially reducing unnecessary biopsies and facilitating real-time decision making in globally underserved regions. ClinicalTrials.gov, NCT 01384708.
dc.language.iso eng
dc.publisher Elsevier
dc.rights This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier.
dc.title Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial
dc.type Journal article
dc.citation.journalTitle Gastroenterology
dc.subject.keywordEarly Detection of Cancer
Endoscopy
Esophageal Neoplasm
dc.citation.volumeNumber 149
dc.citation.issueNumber 2
dc.type.dcmi Text
dc.identifier.doihttps://doi.org/10.1053/j.gastro.2015.04.055
dc.identifier.pmcid PMC4547689
dc.identifier.pmid 25980753
dc.type.publication post-print
dc.citation.firstpage 321
dc.citation.lastpage 329


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