Background. Accurate delineation of tumor margin is essential for complete resection of early gastric cancer (EGC). The objective of this study is to assess the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) for the accurate demarcation of EGC margins. Methods. We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases up to March 2020 to identify eligible studies. The diagnostic accuracy of ME-NBI for EGC margins was calculated, and subgroup analyses were performed based on tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, Helicobacter pylori (H. pylori), and endoscopists’ experience. Besides, we also evaluated the negative and positive resection rates of the horizontal margin (HM) of EGC after endoscopic submucosal dissection (ESD) and surgery. Results. Ten studies comprising 1018 lesions were eligible in the databases. The diagnostic accuracy of ME-NBI for the demarcation of EGC margins was 92.4% (95% confidence interval (CI): 86.7%-96.8%). According to ME-NBI subgroup analyses, the rate of accurate evaluation of EGC margins was not associated with H. pylori infection status, tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, and endoscopists’ experience, and no statistical differences were found in subgroup analyses. Moreover, the negative and positive resection rates of HM after ESD and surgery were 97.4% (95% CI: 92.1%-100%) and 2.6% (95% CI: 0.02%-7.9%), respectively. Conclusions. ME-NBI enables a reliable delineation of the extent of EGC.

中文翻译：

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放大窄带成像对早期胃癌范围的诊断能力：系统评价和荟萃分析

背景。准确勾画肿瘤边缘对于早期胃癌 (EGC) 的完全切除至关重要。本研究的目的是评估放大内窥镜和窄带成像 (ME-NBI) 在准确划分 EGC 边缘时的性能。方法。我们检索了截至 2020 年 3 月的 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆数据库，以确定符合条件的研究。计算ME-NBI对EGC切缘的诊断准确性，并根据肿瘤大小、肿瘤浸润深度、肿瘤占位、肉眼类型、组织学类型、幽门螺杆菌（H. pylori ）进行亚组分析。)，以及内镜医师的经验。此外，我们还评估了内镜黏膜下剥离术（ESD）和手术后EGC水平边缘（HM）的阴性和阳性切除率。结果。包含 1018 个病灶的 10 项研究符合数据库的条件。ME-NBI对EGC边缘划分的诊断准确率为92.4%（95%置信区间（CI）：86.7%-96.8%）。根据 ME-NBI 亚组分析，EGC 切缘的准确评估率与幽门螺杆菌无关感染状态、肿瘤大小、肿瘤浸润深度、肿瘤占位、肉眼类型、组织学类型、内镜医师经验等，亚组分析无统计学差异。此外，ESD和手术后HM的阴性和阳性切除率分别为97.4%（95% CI：92.1%-100%）和2.6%（95% CI：0.02%-7.9%）。结论。ME-NBI 能够可靠地描绘 EGC 的范围。