Diagnostic performance of confocal laser endomicroscopy for atrophy and gastric intestinal metaplasia: A meta-analysis.
OBJECTIVE
To systematically evaluate the diagnostic efficacy of confocal laser endomicroscopy (CLE) for gastric atrophy (GA) and gastric intestinal metaplasia (GIM).


METHODS
Literature search was performed in PubMed and the Cochrane Library for CLE, GA and GIM. The sensitivity, specificity and diagnostic odds ratio (DOR) in diagnosing GA and GIM were pooled for analysis. A summary receiver operating curve (SROC) was documented and the area under the curve was calculated.


RESULTS
Of the 10 studies included in this current analysis, the pooled sensitivity, specificity and DOR of CLE to diagnose GA and GIM were found to be 88%, 98% and 330.85, and 93%, 98% and 439.97, respectively. The area under the SROC were 0.9491 and 0.9812 for the diagnosis of GA and GIM, respectively. Higher sensitivity and specificity of this technique in diagnosing GA and GIM were found in patients without representative disease spectrum and those received pCLE by subgroup analysis.


CONCLUSIONS
CLE is of great value and may be considered an alternative modality for the early diagnosis of GA and GIM.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Tao
T
Bai
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Lei
L
Zhang
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Stuti
S
Sharma
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Yu Dong
YD
Jiang
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Jing
J
Xia
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Huan
H
Wang
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Wei
W
Qian
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Jun
J
Song
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Xiao Hua
XH
Hou
D001284:Atrophy / Q000175:diagnosis; D055088:Early Detection of Cancer / Q000379:methods; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008679:Metaplasia / Q000175:diagnosis; D018613:Microscopy, Confocal / Q000379:methods*; D011230:Precancerous Conditions / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*
atrophy; confocal microscopy; meta-analysis; metaplasia; stomach