BACKGROUND: Management of gastric polyps depends on their histologic composition. A real-time in vivo histologic diagnosis would be valuable to an "on table" management decision. Confocal laser endomicroscopy (CLE), a new diagnostic tool, allows real-time in vivo histologic evaluations of gastrointestinal lesions. This study aimed to assess the feasibility and practicability of using CLE to identify and differentiate gastric hyperplastic polyps and adenomas. METHODS: A total of 66 patients with previously diagnosed polyps were recruited for this study between January 2007 and August 2008 at Qilu Hospital, Shandong University, China. The CLE imaging of hyperplastic polyps and adenomas was performed, and the CLE diagnosis was compared with the gold standard of histopathologic diagnosis. RESULTS: Imaging by CLE was successfully performed for 60 lesions of gastric hyperplastic polyps and 27 lesions of gastric adenomas. Compared with the surrounding background mucosa, gastric hyperplastic polyps and adenomas showed typical distinct appearances, respectively, by CLE. The overall accuracy of the in vivo CLE diagnosis of gastric hyperplastic polyps and adenomas during ongoing endoscopy was 90% (95% confidence interval [CI], 83-96%), and the overall accuracy of differentiating gastric hyperplastic polyps and adenomas by CLE was 97% (95% CI, 90-99%) after endoscopy. Intraobserver agreement was perfect (kappa = 0.92; 95% CI, 0.82-0.99), and interobserver agreement was also good (kappa = 0.83, 95% CI, 0.70-0.96). CONCLUSIONS: This study characterized confocal images of gastric hyperplastic polyps and adenomas as well as the high accuracy of differentiating hyperplastic polyps and adenomas using CLE.
BACKGROUND: Management of gastric polyps depends on their histologic composition. A real-time in vivo histologic diagnosis would be valuable to an "on table" management decision. Confocal laser endomicroscopy (CLE), a new diagnostic tool, allows real-time in vivo histologic evaluations of gastrointestinal lesions. This study aimed to assess the feasibility and practicability of using CLE to identify and differentiate gastric hyperplastic polyps and adenomas. METHODS: A total of 66 patients with previously diagnosed polyps were recruited for this study between January 2007 and August 2008 at Qilu Hospital, Shandong University, China. The CLE imaging of hyperplastic polyps and adenomas was performed, and the CLE diagnosis was compared with the gold standard of histopathologic diagnosis. RESULTS: Imaging by CLE was successfully performed for 60 lesions of gastric hyperplastic polyps and 27 lesions of gastric adenomas. Compared with the surrounding background mucosa, gastric hyperplastic polyps and adenomas showed typical distinct appearances, respectively, by CLE. The overall accuracy of the in vivo CLE diagnosis of gastric hyperplastic polyps and adenomas during ongoing endoscopy was 90% (95% confidence interval [CI], 83-96%), and the overall accuracy of differentiating gastric hyperplastic polyps and adenomas by CLE was 97% (95% CI, 90-99%) after endoscopy. Intraobserver agreement was perfect (kappa = 0.92; 95% CI, 0.82-0.99), and interobserver agreement was also good (kappa = 0.83, 95% CI, 0.70-0.96). CONCLUSIONS: This study characterized confocal images of gastric hyperplastic polyps and adenomas as well as the high accuracy of differentiating hyperplastic polyps and adenomas using CLE.
Authors: Ralf Kiesslich; Liebwin Gossner; Martin Goetz; Alexandra Dahlmann; Michael Vieth; Manfred Stolte; Arthur Hoffman; Michael Jung; Bernhard Nafe; Peter R Galle; Markus F Neurath Journal: Clin Gastroenterol Hepatol Date: 2006-07-13 Impact factor: 11.382
Authors: Y Kakeji; S Yamaguchi; D Yoshida; K Tanoue; M Ueda; A Masunari; T Utsunomiya; M Imamura; H Honda; Y Maehara; M Hashizume Journal: Endoscopy Date: 2006-09 Impact factor: 10.093
Authors: Ralf Kiesslich; Juergen Burg; Michael Vieth; Janina Gnaendiger; Meike Enders; Peter Delaney; Adrian Polglase; Wendy McLaren; Daniela Janell; Steven Thomas; Bernhard Nafe; Peter R Galle; Markus F Neurath Journal: Gastroenterology Date: 2004-09 Impact factor: 22.682
Authors: Dan Ionuţ Gheonea; Tatiana Cârţână; Tudorel Ciurea; Carmen Popescu; Anca Bădărău; Adrian Săftoiu Journal: World J Gastroenterol Date: 2011-01-07 Impact factor: 5.742