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Diagnostic algorithm of magnifying endoscopy with crystal violet staining for non‐ampullary duodenal epithelial tumors
Author(s) -
Toya Yosuke,
Endo Masaki,
Oizumi Tomofumi,
Akasaka Risaburo,
Yanai Shunichi,
Kawasaki Keisuke,
Nakamura Shotaro,
Eizuka Makoto,
Fujita Yasuko,
Uesugi Noriyuki,
Ishida Kazuyuki,
Sugai Tamotsu,
Matsumoto Takayuki
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13640
Subject(s) - medicine , gastroenterology , receiver operating characteristic , endoscopy , mucin , kappa , area under the curve , diagnostic accuracy , pathology , philosophy , linguistics
Objectives Little is known about the usefulness of magnifying endoscopy with crystal violet staining (ME‐CV) for the diagnosis of duodenal tumors. We assessed the ability of ME‐CV to distinguish Vienna classification (VCL) category 4/5 (C4/5) from category 3 (C3) non‐ampullary duodenal epithelial tumors (NADETs). Methods A total of 76 NADETs were studied. We retrospectively analyzed the diagnostic values of the white light endoscopy (WLE) scoring system and the ME‐CV algorithm with receiver operating characteristic (ROC) curves, and three endoscopists calculated the sensitivity, specificity, accuracy, and the area under the curve (AUC) of each. The diagnostic values were tested among NADETs overall and among subgroups of tumors with gastric, gastrointestinal or intestinal mucin phenotypes. Inter‐observer agreement of the diagnostic results was also calculated. Results According to the VCL, 54 lesions (71.1%) were regarded as C3 and 22 lesions (28.9%) as C4/5. The sensitivity, specificity, accuracy and AUC of ME‐CV were higher than those of the WLE scoring system (63.6 vs 54.5, 85.2 vs 75.9, 78.9 vs 69.7, 0.744 vs 0.652, respectively). Inter‐observer agreements of the WLE scoring system and ME‐CV were both moderate (kappa 0.45 and 0.41). ME‐CV had higher sensitivity, specificity, accuracy and AUC than those of the WLE scoring system among the gastric and intestinal phenotypes of NADETs. Conclusions ME‐CV is appropriate for the diagnosis of C4/5 and C3 NADETs.