title: Diagnostic performance of magnifying narrow-band imaging for early gastric cancer: A meta-analysis.
abstract: OBJECTIVE
  To investigate the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) in the diagnosis of early gastric cancer (EGC).
  
  
  METHODS
  Systematic literature searches were conducted until February 2014 in PubMed, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic (ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks' asymmetry test was used to evaluate the publication bias.
  
  
  RESULTS
  Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86 (95%CI: 0.83-0.89), 0.96 (95%CI: 0.95-0.97) and 102.75 (95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivity of 0.57 (95%CI: 0.50-0.64) and a specificity of 0.79 (95%CI: 0.76-0.81). When using "VS" (vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64 (95%CI: 0.52-0.75) and 0.96 (95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74 (95%CI: 0.65-0.82) and 0.98 (95%CI: 0.97-0.98).
  
  
  CONCLUSIONS
  ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Hu
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Qing-Wu
authors.initials: QW
authors.lastname: Lian
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Zheng-Hua
authors.initials: ZH
authors.lastname: Lin
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhong
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Xue
authors.affiliation: Ying-Ying Hu, Qing-Wu Lian, Jing Zhong, Meng Xue, Liang-Jing Wang, Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Liang-Jing
authors.initials: LJ
authors.lastname: Wang
mesh_terms: D019540:Area Under Curve; D016009:Chi-Square Distribution; D055088:Early Detection of Cancer / Q000379:methods*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D062048:Narrow Band Imaging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: Conventional white-light imaging; Early gastric cancer; Magnifying endoscopy; Meta-analysis; Narrow-band imaging