Novel microendoscope ups accuracy of esophageal screening

(HealthDay)—A novel, low-cost, high-resolution microendoscope (HRME) improves the accuracy of Lugol's chromoendoscopy (LCE) for screening and surveillance of esophageal squamous cell neoplasia, according to a study published in the August issue of Gastroenterology.

Marion-Anna Protano, M.D., from Mount Sinai Medical Center in New York City, and colleagues examined the accuracy of HRME as an adjunct to LCE in 147 high-risk patients, enrolled from two U.S. and two Chinese centers.

The researchers found that for LCE versus LCE + HRME, sensitivity was 96 versus 91 percent (P = 0.0832), specificity was 48 versus 88 percent (P < 0.001), positive predictive value was 22 versus 45 percent (P < 0.0001), negative predictive value was 98 versus 98 percent (P = 0.3551), and overall accuracy was 57 versus 90 percent (P < 0.001), using a per-biopsy analysis. In per-patient analysis, the corresponding numbers were 100 versus 95 percent (P = 0.16), 29 versus 79 percent (P < 0.001), 32 versus 60 percent, 100 versus 98 percent, and 47 versus 83 percent (P < 0.001). Sixty percent of biopsies could have been spared using HRME.

"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," the authors write.

One author holds a patent related to optical diagnostic technologies that has been licensed to Remicalm; another author disclosed financial ties to Gilead Pharmaceuticals.

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