A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study

Sep 24, 2026

Prospective pilot evaluation of how endocytoscopy compares with magnifying endoscopy using narrow-band imaging (ME-NBI) for diagnosing gastric lesions in vivo. The study registered 24 patients with gastric neoplasms and retrospectively reviewed endoscopic images across white light, ME-NBI, and endocytoscopy by three endoscopists. Diagnostic yield for early gastric cancer (EGC) was assessed against histopathology. Endocytoscopy showed favorable sensitivity, specificity, accuracy, and good inter-observer agreement, with results not inferior to NBI.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background/aims

Methods

Results

Conclusion

Introduction

Key clinical context: gastric cancer and early diagnosis

Endoscopic imaging technologies: WLI, IEE, ME-NBI, NBI, endocytoscopy

Original article A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study In Kyung Yooa* , Jun Chul Parkb* , Hyuk Leec , Abdullah Ozgur Yeniovad , Jeong Hoon Leee , Dong Keon Yonf, Joo Young Chog and Wan-Sik Leeh | Background/aims Endoscopic technologies have recently advanced to optimize the detection and diagnosis of gastric lesions. Endocytoscopy aids in the virtual realization of histology. Herein, we aimed to investigate gastric lesions using single-stain endocytoscopy and compare them using magnifying endoscopy with narrow-band imaging (ME-NBI) in terms of diagnostic yield in vivo.
Methods and methods In the present prospective study we registered 24 patients with gastric neoplasms and | | --- | | ,
retrospectively reviewed their images. Three endoscopists reviewed the images of gastric neoplasms using white light, ME-NBI, and endocytoscopy. The diagnostic yield of endocytoscopy in early gastric cancer (EGC) was assessed using histopathology as the gold standard.
Results Endocytoscopy was performed in 24 patients with gastric neoplasms. Of these, 15 patients had adenocarcinomas, while nine patients had low-grade dysplasia. The sensitivity, specificity, and accuracy of endocytoscopy for EGC detection were reported as 80.0%[95% confidence interval (CI), 51.9–95.7], 66.7%(95% CI, 58.4–91.9), and 75.0%(95% CI, 53.3–90.2) by endoscopist A; 80.0%(95% CI, 51.9–95.7), 44.4%(95% CI, 13.7–78.8), and 66.7%(95% CI, 44.7–84.4) by endoscopist B; and 93.3%(95% CI, 68.1–99.8), 55.6%(95% CI, 21.2–86.3), and 79.2%(95% CI, 57.9–92.8) by endoscopist C; these findings were not inferior to NBI. The inter-observer agreement, κ statistic = 0.67 (95% CI, 0.43–0.90) was favorable. Conclusion Endocytoscopy aid in the diagnosis of EGC because of its better sensitivity and accuracy compared to NBI or white-light imaging. However, further large-scale studies are required to confirm our findings. Eur J Gastroenterol Hepatol 35 :
530–536
Copyright © 2023 The Author(s) . Published by Wolters Kluwer Health, Inc. | Introduction Gastric cancer is one of the leading causes of cancer-related deaths. Although its prevalence is decreasing, it is European Journal of Gastroenterology & Hepatology 2023, 35:530–536 Keywords: early gastric cancer, endocytoscopy, magnifying endoscopy with narrow-band imaging, white-light imaging aDepartment of Gastroenterology, Cha Bundang Medical Center, Cha University College of Medicine, Seongnam-si, bDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, cDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, dDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey, eDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, fDepartment of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, gDepartment of Gastroenterology, CHA Gangnam Medical Center, College of Medicine, Cha University, Seoul and hDepartment of Internal Medicine, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea Correspondence to Wan Sik Lee, MD, PhD, Department of Internal Medicine, Chonnam National University Medical School, 322, Seoyang-ro, Hwasun-eup, Hwasun, Jeollanam-do 58128, Republic of Korea Tel: +82 62 220 6296; e-mail: [jadelook@hanmail.net](jadelook@hanmail.net)[ ](jadelook@hanmail.net)[Received](Received 10 October 2022 Accepted 8 January 2023)[ 10 October 2022](Received 10 October 2022 Accepted 8 January 2023)[ Accepted](Received 10 October 2022 Accepted 8 January 2023)[ 8 January 2023](Received 10 October 2022 Accepted 8 January 2023) . This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-

FAQs

What is the goal of this pilot study?

To investigate gastric lesions using single-stain endocytoscopy and compare its in vivo diagnostic yield with magnifying endoscopy using narrow-band imaging (ME-NBI).

How were patients and images handled in the study?

Twenty-four patients with gastric neoplasms were registered prospectively, and their images were retrospectively reviewed. Three endoscopists assessed findings using white light, ME-NBI, and endocytoscopy.

How did endocytoscopy perform for detecting early gastric cancer?

Sensitivity, specificity, and accuracy were reported for three endoscopists, and the findings were not inferior to NBI. Inter-observer agreement was favorable (κ=0.67).

What conclusion does the study draw about endocytoscopy?

Endocytoscopy may aid diagnosis of early gastric cancer due to better sensitivity and accuracy compared with NBI or white-light imaging, while larger studies are needed to confirm results.

Sep 24, 2026

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