Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection

Jun Chul Park, Yehyun Park, Hyun Ki Kim, Jeong Hyeon Jo, Chan Hyuk Park, Eun Hye Kim, Hyun Da Jung, Hyunsoo Chung, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and Aim: We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). Methods: We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Results: Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6% vs 93.2%, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9% vs 27.6%, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Conclusions: Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation.

Original languageEnglish
Pages (from-to)1046-1054
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume32
Issue number5
DOIs
Publication statusPublished - 2017 May

Fingerprint

Stomach Neoplasms
Lasers
Endoscopic Mucosal Resection
Electrocoagulation
Tertiary Care Centers
Linear Models
Neoplasms
Light

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Park, Jun Chul ; Park, Yehyun ; Kim, Hyun Ki ; Jo, Jeong Hyeon ; Park, Chan Hyuk ; Kim, Eun Hye ; Da Jung, Hyun ; Chung, Hyunsoo ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Yong Chan. / Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection. In: Journal of Gastroenterology and Hepatology (Australia). 2017 ; Vol. 32, No. 5. pp. 1046-1054.
@article{5718ba6fb7cf4641904b07c58e5ee843,
title = "Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection",
abstract = "Background and Aim: We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). Methods: We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Results: Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6{\%} vs 93.2{\%}, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9{\%} vs 27.6{\%}, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Conclusions: Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation.",
author = "Park, {Jun Chul} and Yehyun Park and Kim, {Hyun Ki} and Jo, {Jeong Hyeon} and Park, {Chan Hyuk} and Kim, {Eun Hye} and {Da Jung}, Hyun and Hyunsoo Chung and Shin, {Sung Kwan} and Lee, {Sang Kil} and Lee, {Yong Chan}",
year = "2017",
month = "5",
doi = "10.1111/jgh.13635",
language = "English",
volume = "32",
pages = "1046--1054",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "5",

}

Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection. / Park, Jun Chul; Park, Yehyun; Kim, Hyun Ki; Jo, Jeong Hyeon; Park, Chan Hyuk; Kim, Eun Hye; Da Jung, Hyun; Chung, Hyunsoo; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 32, No. 5, 05.2017, p. 1046-1054.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Probe-based confocal laser endomicroscopy in the margin delineation of early gastric cancer for endoscopic submucosal dissection

AU - Park, Jun Chul

AU - Park, Yehyun

AU - Kim, Hyun Ki

AU - Jo, Jeong Hyeon

AU - Park, Chan Hyuk

AU - Kim, Eun Hye

AU - Da Jung, Hyun

AU - Chung, Hyunsoo

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Yong Chan

PY - 2017/5

Y1 - 2017/5

N2 - Background and Aim: We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). Methods: We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Results: Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6% vs 93.2%, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9% vs 27.6%, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Conclusions: Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation.

AB - Background and Aim: We evaluated probe-based confocal laser endomicroscopy (pCLE) in the margin delineation of early gastric cancer (EGC) for endoscopic submucosal dissection in comparison with white-light imaging with chromoendoscopy (CE). Methods: We conducted a prospective, randomized controlled study from November 2013 to October 2014 in a tertiary referral hospital. A total of 101 patients scheduled for endoscopic submucosal dissection due to differentiated EGC were randomized into pCLE and CE groups (pCLE 51, CE 50). Markings were made by electrocautery at the proximal and distal tumor margins, as determined by either pCLE or CE. The distance from the marking to the tumor margin was measured in the resected specimen histopathologically and was compared between the two groups by a linear mixed model. Results: Among 104 lesions, 80 lesions with 149 markings (pCLE 68, CE 81) were analyzed after excluding undifferentiated EGCs (n = 8) and unidentifiable markings (n = 13). Although the complete resection rate showed no difference between the groups (94.6% vs 93.2%, P = 1.000), the median distance from the marking to the margin was shorter in the pCLE group (1.3 vs 1.8 mm, P = 0.525) and the proportion of the distance <1 mm was higher (43.9% vs 27.6%, P = 0.023) in the pCLE group. Finally, subgroup analysis with superficial flat lesions (18 lesions, 31 marking dots) showed a significantly decreased distance in the pCLE group (0.5 vs 3.1 mm, P = 0.007). Conclusions: Among EGCs with superficial flat morphology, in which the accurate evaluation of lateral extent is difficult with CE, pCLE would be useful for more precise margin delineation.

UR - http://www.scopus.com/inward/record.url?scp=85018700340&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018700340&partnerID=8YFLogxK

U2 - 10.1111/jgh.13635

DO - 10.1111/jgh.13635

M3 - Article

C2 - 27862291

AN - SCOPUS:85018700340

VL - 32

SP - 1046

EP - 1054

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 5

ER -