Diagnostics of focal lesions in the stomach with combined specifying techniques

Purpose. To assess the diagnostic value of esophagogastroduodenoscopy (EGDS) added with modern visualization techniques NBI, ZOOM and confocal laser endomicroscopy so as to reveal focal neoplasms in the stomach mucous. Place: Moscow, state budget - funded organizations “United Hospital and Out-Patient Unit” and “Central State Medical Academy” subordinate to the Affair Management Department of the President of Russian Federation. Materials and methods: 150 patients aged 29-96 were examined. EGDS was added with NBI, ZOOM and confocal laser endomicroscopy with the target biopsy. Macroscopic and endomicroscopic pictures of various neoplasms ( metaplasia, hyperplasia, adenoma, dysplasia, cancer) were compared with findings of histological examination. CLEM testing was made using Cellvizio system developed by the French firm «Mauna Kea Technologies». The techniques discussed above verified 176 focal neoplasms in the stomach mucous. Results. A diagnostic value of complex endoscopic examination including NBI, ZOOM and CLEM has been assessed. For the intestinal metaplasia the diagnostic sensitivity, specificity, and accuracy were 94.2%, 84.7% and 90.3%, respectively. In dysplasia/cancer cases the diagnostic sensitivity, specificity and accuracy were 93.7%, 87.8% and 89.8%, respectively. Conclusion. EDGS added with NBI, ZOOM and CLEM considerably increases the diagnostic effectiveness in revealing focal lesions in the stomach mucous and allows to define the histological structure of neoplasms in vivo.

диагностика рака желудка, эндоскопия, конфокальная лазерная эндомикроскопия, diagnostics of gastric cancer, endoscopy, confocal laser endomicroscopy

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