Endoscopy 2018; 50(04): S52-S53
DOI: 10.1055/s-0038-1637184
ESGE Days 2018 oral presentations
20.04.2018 – Best abstract awards
Georg Thieme Verlag KG Stuttgart · New York

NARROW-BAND IMAGING (NBI) VERSUS LUGOL CHROMOENDOSCOPY IN THE DETECTION OF OESOPHAGUS SQUAMOUS NEOPLASMS IN A HIGH-RISK POPULATION: A REAL-LIFE RANDOMISED CONTROLLED MULTICENTRE TRIAL

M Gruner
1   Edouard Herriot Hospital, Lyon, France
,
A Denis
2   Hospices Civils de Lyon, Pôle IMER, Lyon, France
,
C Masliah
3   Clinique Mutualiste de l'Estuaire, Saint Nazaire, France
,
M Amil
4   Centre Hospitalier les Oudairies, La Roche sur Lyon, France
,
E Metivier-Cesbron
5   Centre Hospitalo-Universitaire d'Angers, Site Larrey, Angers, France
,
D Luet
5   Centre Hospitalo-Universitaire d'Angers, Site Larrey, Angers, France
,
M Kaasis
6   Centre Hospitalier de Cholet, Cholet, France
,
E Coron
7   Hotel Dieu, Hepatogastroenterology Department, Nantes, France
,
M Le Rhun
7   Hotel Dieu, Hepatogastroenterology Department, Nantes, France
,
S Lecleire
8   Charles Nicolle Hospital, Rouen, France
,
M Antonietti
8   Charles Nicolle Hospital, Rouen, France
,
JL Legoux
9   La Source Hospital, Orléans, France
,
L Lefrou
9   La Source Hospital, Orléans, France
,
P Renkes
10   Clinique Claude Bernard Hospital, Metz, France
,
AL Tarreirrias
11   Foch Hospital, Suresnes, France
,
P Balian
11   Foch Hospital, Suresnes, France
,
P Rey
12   Hopital d'Instruction des Armées, Legouest, Metz, France
,
B Prost
13   Saint Joseph, Saint Luc Hospital, Lyon, France
,
C Cellier
14   Hopital Européen Georges Pompidou, Paris, France
,
G Rahmi
14   Hopital Européen Georges Pompidou, Paris, France
,
S Elia
14   Hopital Européen Georges Pompidou, Paris, France
,
S Fratte
15   Centre Hospitalier de Belfort, Belfort, France
,
B Guerrier
16   Centre Hospitalier de Bourg-en-Bresse, Bourg-en-Bresse, France
,
S Touzet
2   Hospices Civils de Lyon, Pôle IMER, Lyon, France
,
T Ponchon
1   Edouard Herriot Hospital, Lyon, France
17   Lyon 1 University Claude Bernard, Lyon, France
18   INSERM U1032, LabTAU, Lyon, France
,
M Pioche
17   Lyon 1 University Claude Bernard, Lyon, France
18   INSERM U1032, LabTAU, Lyon, France
19   Hopital Edouard Herriot, Lyon, France
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Narrow-Band Imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect oesophageal squamous cell carcinoma (SCC) and appears more specific than Lugol chromoendoscopy in expert centres but its specificity in current practice is not known. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy to detect oesophageal SCC and high-grade dysplasia (HGD) in current practice (including tertiary care centres, local hospitals and private clinics).

Methods:

We conducted a prospective randomized multicentre trial including all patients, addressed for a gastroscopy, with previous or current SCC of the upper aerodigestive tract. Patients included were randomly allocated either to the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, a NBI examination was added between white light and Lugol chromoendoscopy. In both groups, the gastroscopy was realised by a single operator performing the successive examinations without blinding. Once detected, all lesions were biopsied to confirm or to reject the histology diagnosis of SCC or dysplasia. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis.

Results:

Among the 335 patients included in 14 French institutions from March 2011 to December 2015, 315 were analysed (Lugol group n = 159, NBI group n = 156). In a per-patient analysis, sensitivity, specificity, positive and negative likelihood values were respectively 100%, 79.1%, 37%, and 100% for NBI vs. 100%, 61.1%, 23.9%, and 100% for Lugol chromoendoscopy. The NBI specificity was significantly greater than that of Lugol chromoendoscopy (p < 0.001).

Conclusions:

We show here the superiority of NBI specificity over Lugol chromoendoscopy to detect oesophageal SCC and HGD in current gastroenterology practice.