Gastric cancer: Prevention, screening and early diagnosis

Table 1 Narrow-band imaging endoscopy for early gastric cancer/dysplasia diagnosis

Ref.	Endoscopic technique	Mucosal and vascular pattern for GC	Accuracy
Kaise et al[151]	NBI-ME for superficial depressed gastric lesions vs WLE	The triad: Absence of fine mucosal structure with microvascular dilation and heterogeneity	NBI-ME specificity (85%, theoretically calculated if all of the triad were positive), which was significantly (P < 0.001) superior to WLE general diagnosis (65%)
Kato et al[152]	NBI-ME vs WLE	The triad: Absence of fine mucosal structure with microvascular dilation and heterogeneity	NBI-ME sensitivity (93%) and specificity (95%)
Ezoe et al[153]	NBI-ME vs WLE	Irregular V pattern with a mucosal DL	NBI the diagnostic accuracy was significantly higher for than for WLI (79% vs 44%; P = 0.0001), as was its sensitivity (70% vs 33%; P = 0.0005). The diagnostic specificity of NBI (89%) was higher than that of WLI (67%), but the difference was not statistically significant
Capelle et al[154]	NBI without ME	Complete loss of architectural and mucosal pattern	The sensitivity, specificity, PPV and NPV for detection of premalignant lesions were 71%, 58%, 65% and 65% for NBI and 51%, 67%, 62% and 55% for WLE, respectively
Maki et al[155]	NBI-ME vs WLE to differentiate between cancer and adenoma in superficial elevated lesions of the stomach	WLE: Red coloring NBI-ME: An irregular V pattern with a DL, or irregular S pattern with a DL	The sensitivity, specificity, and accuracy of WLE vs NBI-ME were 64% (52%-76%) vs 95% (90%-100%), 94% (86%-100%) vs 88% (77%-99 %), and 74% (66%-83%) vs 92% (86%-98%), respectively
Tsuji et al[156]	NBI-ME	VS classification: (1) irregular V pattern with a DL between the lesion and the surrounding area; and (2) irregular S pattern with a DL between the lesion and the surrounding area	Sensitivity and specificity for carcinoma were 75.0% and 84.9%, respectively. PPV was 81.4%
Omori et al[157]	NBI-ME	Fine network (net-like appearance consisted of irregular shaped micro vessels), core vascular (clearly visible coiled or wavy vessels in the central area of the mucosal structure), and unclear patterns (micro vascular patterns is not observed)	Sensitivity 86.2%, specificity 97.0%
Wang et al[158]	NBI-ME vs CLE	NBI: “VS” classification system	Accuracy of the CLE and the NBI-ME diagnosis was 88% (95%CI: 78%-98%) and 81% (95%CI: 69%-93%), respectively
Kaise et al[159]	NBI-ME vs WLE	The triad: Disappearance of fine mucosal structure, microvascular dilation, and heterogeneity	The sensitivity and specificity for NBI-ME diagnosis using the triad (92.9% and 94.7%, respectively) were significantly better than those for WLE (42.9% and 61.0%, respectively)
Pimentel-Nunes et al[160]	NBI	“Irregular vessels and mucosa” (pattern C)	Accuracy 95%; 95%CI: 90%-99%; LR+ = 44.33

EGC: Early gastric cancer; GC: Gastric cancer; NBI-ME: Narrow-band imaging with or without magnification.