Abstract
Background and Aim: Endoscopic surveillance for dysplasia in Barrett's esophagus (BE) with random biopsies is the primary diagnostic tool for monitoring clinical progression into esophageal adenocarcinoma. As an alternative, narrow-band imaging (NBI) endoscopy offers targeted biopsies that can improve dysplasia detection. This study aimed to evaluate NBI-guided targeted biopsies' diagnostic accuracy for detecting dysplasia in patients undergoing endoscopic BE surveillance compared with the widely used Seattle protocol. Methods: Cochrane DTA Register, MEDLINE/PubMed, EMBASE, OpenGrey, and bibliographies of identified papers were searched until 2018. Two independent investigators resolved discrepancies by consensus, study selection, data extraction, and quality assessment. Data on sensitivity, specificity, and predictive values were pooled and analyzed using a random-effects model. Results: Of 9528 identified articles, six studies comprising 493 participants were eligible for quantitative synthesis. NBI-targeted biopsy showed high diagnostic accuracy in detection of dysplasia in BE with a sensitivity of 76% (95% confidence interval [CI]: 0.61–0.91), specificity of 99% (95% CI: 0.99–1.00), positive predictive value of 97% (95% CI: 0.96–0.99), and negative predictive value of 84% (95% CI: 0.69–0.99) for detection of all grades of dysplasia. The receiver-operating characteristic curve for NBI model performance was 0.8550 for detecting all dysplasia. Conclusion: Narrow-band imaging-guided biopsy demonstrated high diagnostic accuracy and might constitute a valid substitute for random biopsies during endoscopic surveillance for dysplasia in BE.
| Original language | English |
|---|---|
| Pages (from-to) | 2659-2671 |
| Number of pages | 13 |
| Journal | Journal of Gastroenterology and Hepatology (Australia) |
| Volume | 36 |
| Issue number | 10 |
| Early online date | 13 Jun 2021 |
| DOIs | |
| Publication status | Published - Oct 2021 |
Bibliographical note
Funding Information:This work is part of a master's thesis of the Master's Program in Clinical Research, Center for Clinical Research and Management Education, Division of Healthcare Sciences, Dresden International University, Dresden, Germany. The authors thank Denny John (Campbell Collaboration, India) for writing a paragraph in the first draft proposal. The authors thank Simone Krautz (DIU) for providing access to some of the needed full-text journal articles.
Dr Siepmann received grants from the Michael J. Fox Foundation, the Kurt‐Goldstein‐Institute, the German Parkinson's Disease Foundation (Deutsche Gesellschaft für Parkinson und Bewegungsstörungen), and the German Ministry of Health (Bundesministerium für Gesundheit) that were not related to this work. Declaration of conflict of interest
Publisher Copyright:
© 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Keywords
- Barrett's esophagus
- esophageal adenocarcinoma
- narrow-band imaging endoscopy
- random biopsy
- targeted biopsy
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
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