title: Detection of superficial esophageal squamous cell neoplasia by chromoendoscopy-guided confocal laser endomicroscopy.
abstract: OBJECTIVE
  To evaluate the diagnostic potential of Lugol's chromoendoscopy-guided confocal laser endomicroscopy (CLE) in detecting superficial esophageal squamous cell neoplasia (ESCN).
  
  
  METHODS
  Between December 2008 and September 2010, a total of 52 patients were enrolled at the Chinese PLA General Hospital in Beijing, China. First, Lugol's chromoendoscopy-guided CLE was performed in these patients and the CLE in vivo histological diagnosis was recorded. Then, chromoendoscopy-guided biopsy was performed in the same patients by another endoscopist who was blinded to the CLE findings. Based on the biopsy and CLE diagnosis, en bloc endoscopic resection was performed. The CLE in vivo diagnosis and the histological diagnosis of biopsy of ESCN were compared, using a histological examination of the endoscopic resection specimens as the standard reference.
  
  
  RESULTS
  A total of 152 chromoendoscopy-guided biopsies were obtained from 56 lesions. In the 56 lesions of 52 patients, a total of 679 CLE images were obtained vs 152 corresponding biopsies. The sensitivity, specificity, negative predictive value and positive predictive value of chromoendoscopy-guided CLE compared with biopsy were 95.7% vs 82% (P < 0.05), 90% vs 70% (P < 0.05), 81.8% vs 46.7% (P < 0.05), and 97.8% vs 92.7% (P > 0.05), respectively. There was a significant improvement in sensitivity, specificity, negative predictive value, and accuracy when comparing chromoendoscopy-guided CLE with biopsy.
  
  
  CONCLUSIONS
  Lugol's chromoendoscopy-guided CLE is a real-time, non-invasive endoscopic diagnostic technology; the accuracy of the detection of superficial ESCN is equivalent to or may be superior to biopsy histology.
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Yun-Sheng
authors.initials: YS
authors.lastname: Yang
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Zhong-Sheng
authors.initials: ZS
authors.lastname: Lu
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Shuang-Fang
authors.initials: SF
authors.lastname: Wang
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.affiliation: Jin Huang, Department of Gastroenterology and Hepatology, Chinese PLA 153 Hospital, Zhengzhou 450000, Henan Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002681:China; D002863:Chromogenic Compounds; D004938:Esophageal Neoplasms / Q000473:pathology*; D000077277:Esophageal Squamous Cell Carcinoma; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007454:Iodides; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D002863:Chromogenic Compounds; D007454:Iodides; C010389:Lugol's solution
keywords: Chromoendoscopy; Confocal endomicroscopy; Endoscopic submucosal dissection; Squamous cell neoplasm; Superficial esophageal neoplasia