Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 24:12:809822.
doi: 10.3389/fonc.2022.809822. eCollection 2022.

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

Suya Pang  1 , Hailing Yao  1 , Chen Jiang  1 , Qin Zhang  2 , Rong Lin  1
Affiliations

Confocal Laser Endomicroscopy Can Improve the Diagnosis Rate and Range Assessment of Patients With Conflicting Chronic Atrophic Gastritis Results of White Light Endoscopic and Pathological Diagnosis

Suya Pang et al. Front Oncol. .

Abstract

Background and aims: Chronic atrophic gastritis (CAG) is closely related to the development of gastric cancer. However, the diagnostic accuracy of white light endoscopy (WLE) biopsy for CAG is poor. The diagnostic role and efficacy of confocal laser endomicroscopy (CLE) in CAG missed under WLE biopsy remain unclear.

Methods: This study is a single-center prospective study that included 21 patients from 1,349 patients who underwent WLE and biopsy and whose WLE results confirmed CAG, but pathological results did not. Then, all these patients received CLE examination and underwent targeted biopsies and five-point standard biopsies. The sensitivity, specificity, and accuracy of CLE diagnosis and targeted biopsy were analyzed.

Results: The pathological results of five-point standard biopsies in 21 patients confirmed CAG, and 17 patients (81.0%) were confirmed to have intestinal metaplasia (IM). According to the image diagnosis of CLE, there were 19 cases (90.5%) of CAG and 14 cases (66.7%) of IM among these 21 patients. According to the targeted biopsy of CLE, 17 cases (81.0%) of CAG and 14 cases (66.7%) of IM were diagnosed. There was no significant difference between CLE image diagnosis and five-point standard biopsies in terms of atrophy severity score (p = 0.927), IM severity score (p = 0.250), atrophy scope score (p = 0.781), and IM scope score (p = 0.195). For CAG, the sensitivity and accuracy of CLE image diagnosis were higher than those of CLE targeted biopsies (90.5% vs. 81.0%, p = 0.331), but for IM, the diagnosis was the same.

Conclusions: CLE can improve the diagnosis rate of CAG and can increase the comprehensive assessment of the scope and severity of CAG.

Keywords: chronic atrophic gastritis; confocal laser endomicroscopy; gastric cancer; pathology; white light endoscopy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Confocal imaging and histopathology of gastric epithelium. (A) Normal gastric epithelium. (B) Mild atrophic gastritis and intestinal metaplasia. (C) Moderate atrophic gastritis and intestinal metaplasia. (D) Severe atrophic gastritis and intestinal metaplasia.
See this image and copyright information in PMC

References

    1. Kamangar F, Dores G, Anderson W. Patterns of Cancer Incidence, Mortality, and Prevalence Across Five Continents: Defining Priorities to Reduce Cancer Disparities in Different Geographic Regions of the World. J Clin Oncol Off J Am Soc Clin Oncol (2006) 24(14):2137–50. doi: 10.1200/JCO.2005.05.2308 - DOI - PubMed
    1. Islami F, Sheikhattari P, Ren J, Kamangar F. Gastric Atrophy and Risk of Oesophageal Cancer and Gastric Cardia Adenocarcinoma–A Systematic Review and Meta-Analysis. Ann Oncol Off J Eur Soc Med Oncol (2011) 22(4):754–60. doi: 10.1093/annonc/mdq411 - DOI - PubMed
    1. Weck MN, Brenner H. Prevalence of Chronic Atrophic Gastritis in Different Parts of the World. Cancer Epidemiol Biomark Prev (2006) 15(6):1083–94. doi: 10.1158/1055-9965.EPI-05-0931 - DOI - PubMed
    1. Yu X, Chen J, Zheng L, Song J, Lin R, Hou X, et al. . Quantitative Diagnosis of Atrophic Gastritis by Probe-Based Confocal Laser Endomicroscopy. BioMed Res Int (2020) 2020:9847591. doi: 10.1155/2020/9847591 - DOI - PMC - PubMed
    1. Du Y, Bai Y, Xie P, Fang J, Wang X, Hou X, et al. . Chronic Gastritis in China: A National Multi-Center Survey. BMC Gastroenterol (2014) 14:21. doi: 10.1186/1471-230X-14-21 - DOI - PMC - PubMed