标题：In vivo real-time diagnosis of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in gastric subepithelial lesions
作者：Zhang, Ming-Ming; Zhong, Ning; Gu, Xiang; Wang, Xiao; Zuo, Xiu-Li; Ji, Rui; Li, Chang-Qing; Li, Li-Xiang; Li, Zhen; Yu, Yan-Bo; Li 更多 作者机构：[Zhang, Ming-Ming; Zhong, Ning; Gu, Xiang; Zuo, Xiu-Li; Ji, Rui; Li, Chang-Qing; Li, Li-Xiang; Li, Zhen; Yu, Yan-Bo; Li, Yan-Qing] Shandong Univ, Qilu 更多
通讯作者地址：[Li, YQ]Shandong Univ, Qilu Hosp, Dept Gastroenterol, Lab Translat Gastroenterol, 107 Wenhuaxi Rd, Jinan 250012, Shandong, Peoples R China.
来源：JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
关键词：endoscopic ultrasound; gastric subepithelial lesions; needle-based; confocal laser endomicroscopy; real-time diagnosis
摘要：Background and Aim The effect of real-time analysis of needle-based confocal laser endomicroscopy (nCLE) for gastric subepithelial lesions (SELs) on the diagnostic value is unclear. The study aimed to investigate the diagnostic efficacy of real-time nCLE for gastric SELs and to assess the technical aspects and safety of real-time nCLE. Methods Consecutive patients with gastric SELs >= 1 cm were prospectively investigated by endoscopic ultrasound (EUS), followed by nCLE. During EUS-nCLE, real-time nCLE diagnosis was made by an expert endoscopist. The procedure-relative adverse events were assessed and recorded. One-month washout period later, nCLE videos were reviewed off-line by the same endoscopist. The nCLE diagnoses were compared with corresponding pathological results. Additionally, image quality and interobserver agreements for the criteria were evaluated by three experienced endomicroscopists. Results Except for one failing to be punctured, 60 patients completed EUS-nCLE procedures successfully. Real-time nCLE had high diagnostic accuracies of >= 88.3% for gastric SELs. There were no significant differences between real-time and off-line nCLE diagnoses for gastric SELs (P > 0.05). The overall accuracy of real-time nCLE for diagnosis of gastric SELs was 86.7%. There were no procedure-relative adverse events occurred. In addition, the mean image quality score was 3.6 (1 = poor and 5 = excellent). The interobserver agreement was "almost perfect" for ectopic pancreas and "substantial" for gastrointestinal stromal tumor, leiomyoma, and carcinoma. Conclusions Endoscopic ultrasound-nCLE could provide in vivo real-time diagnostic imaging with a high diagnostic accuracy. Meanwhile, real-time nCLE was feasible and had a satisfactory safety profile.