Background and Aims

Blue laser imaging-bright (BLI-bright) has shown promise as a more useful tool for detection of early gastric cancer (EGC) than white-light imaging (WLI). However, the diagnostic performance of BLI-bright in the detection of EGC has not been investigated. We aimed to compare real-time detection rates of WLI with that of BLI-bright for EGC.

Methods

This was a prospective, randomized, controlled study in 2 Japanese academic centers. We investigated 629 patients undergoing follow-up endoscopy for atrophic gastritis with intestinal metaplasia or surveillance after endoscopic resection of EGC. Patients were randomly assigned to receive primary WLI followed by BLI-bright or primary BLI-bright followed by WLI. The real-time detection rates of EGC were compared between primary WLI and primary BLI-bright.

Results

There were 298 patients in each group. The real-time detection rate of EGC with primary BLI-bright was significantly greater than that with primary WLI (93.1% vs 50.0%; P = .001). Primary BLI-bright had a significantly greater ability to detect EGCs in patients with a history of endoscopic resection for EGC, no Helicobacter pylori infection in the stomach after eradication therapy, lesions with an open-type atrophic border, lesions in the lower third of the stomach, depressed-type lesions, small lesions measuring <10 mm and 10 to 20 mm in diameter, reddish lesions, well-differentiated adenocarcinomas, and lesions with a depth of invasion of T1a.

Conclusions

BLI-bright has a higher real-time detection rate for EGC than WLI. BLI-bright should be performed during surveillance endoscopy in patients at high risk for EGC. (Clinical trial registration number: UMIN000011324.)

中文翻译：

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蓝光激光成像提高了早期胃癌的实时检测率：一项随机对照研究

背景和目标

与白光成像（WLI）相比，蓝光成像（BLI-bright）显示出有望成为早期胃癌（EGC）检测的更有用工具。但是，尚未研究BLI-bright在EGC检测中的诊断性能。我们旨在比较ELI的WLI和BLI-bright的实时检测率。

方法

这是在两个日本学术中心进行的前瞻性，随机对照研究。我们调查了629例接受内镜切除EGC的胃内萎缩性胃炎伴肠上皮化生或随访的内镜随访患者。随机分配患者接受原发性WLI，然后接受BLI亮或原发性BLI明亮，再接受WLI。比较了主要WLI和主要BLI-bright之间的EGC实时检测率。

结果

每组有298例患者。原发性BLI亮的EGC实时检测率显着高于原发性WLI的实时检测率（93.1％vs 50.0％；P  = .001）。有内镜切除史的EGC，根除治疗后胃中无幽门螺杆菌感染，具有开放型萎缩性边界的病灶，位于病灶下部三分之一的病灶，原发性BLI-bright具有明显更高的检测EGC的能力。胃，凹陷型病变，直径小于10毫米，直径10至20毫米的小病变，微红的病变，分化良好的腺癌以及T1a浸润深度的病变。

结论

BLI-bright对EGC的实时检测率比WLI高。对于EGC高危患者，在监测内窥镜检查期间应进行BLI-bright检查。（临床试验注册号：UMIN000011324。）