title: Meta-analysis of confocal laser endomicroscopy for the diagnosis of gastric neoplasia and adenocarcinoma.
abstract: OBJECTIVE
  Confocal laser endomicroscopy (CLE) is a recently developed technique used to diagnose gastrointestinal diseases. The current meta-analysis aimed to systematically assess the ability of CLE to diagnose neoplasia and gastric adenocarcinoma.
  
  
  METHODS
  A comprehensive literature search was performed using PubMed, Embase and the Cochrane Library for endomicroscopy, gastric neoplasia and gastric adenocarcinoma. Sensitivity and specificity data on the diagnosis of neoplasia and gastric adenocarcinoma were pooled. A summary receiver operating characteristic (sROC) curve was performed and the area under the curve was calculated.
  
  
  RESULTS
  In all, 13 studies were included in the current study. The pooled sensitivity and specificity assessing CLE as a method to diagnose gastric neoplasia were 0.81 and 0.98, respectively. For the diagnosis of gastric adenocarcinoma, the pooled sensitivity and specificity were 0.89 and 0.99, respectively. The pooled sensitivity and specificity were 0.82 and 0.95 when differentiating high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia. Additionally, the pooled sensitivity and specificity were 0.87 and 0.96, respectively, when distinguishing undifferentiated gastric adenocarcinoma from differentiated gastric adenocarcinoma.
  
  
  CONCLUSIONS
  CLE has a high sensitivity and specificity for diagnosing gastric intraepithelial neoplasia and gastric adenocarcinoma; therefore, it could be considered an alternative to the endoscopic method used to diagnose gastric intraepithelial neoplasia and gastric adenocarcinoma.
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qian
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Bai
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Song
authors.affiliation: Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Xiao Hua
authors.initials: XH
authors.lastname: Hou
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D018613:Microscopy, Confocal / Q000379:methods*; D060787:Neoplasm Grading; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
keywords: adenocarcinoma; confocal laser endomicroscopy; meta-analysis; stomach neoplasms