Diagnostic value of probe-based confocal laser microendoscopy in differential diagnosis of fundic gland polyps

Abstract

Objective To explore the value of probe-based confocal laser endomicroscopy (pCLE) in the differential diagnosis of fundic gland polyps. Methods A total of 63 patients who underwent conventional white light image (WLI) and suggested with gastric polyps in our gastroenterology endoscopy center during June and December 2023 were enrolled, and their clinical data, WLI, narrow band images (NBI), pCLE images and postoperative histopathological findings were collected. The characteristics of fundic gland polyps under pCLE were statistically verified, and the sensitivity, specificity, accuracy and consistency of different endoscopic diagnoses were calculated respectively. Results Under pCLE, fundic gland polyps were mainly manifested as elongated gastric pit opening, "hand-in-hand" gastric pit opening, well-arranged blood vessels around the pit opening, and no luciferin oozing. The sensitivity, specificity, accuracy of WLI were 72.73%, 75.00%, 73.13% and 0.343 for fundic gland polyps, and 81.82%, 71.43%, 71.64% and 0.354 for hyperplastic polyps, respectively. While, the above values of NBI were 87.27%, 83.33%, 86.57% and 0.673 for fundic gland polyps, and 81.82%, 85.71%, 85.07% and 0.554 for hyperplastic polyps; and those of pCLE were 92.73%, 91.67%, 92.53% and 0.769 for fundic gland polyps, and 90.91%, 94.64%, 94.03% and 0.797 for hyperplastic polyps pCLE had better sensitivity, specificity and accuracy than WLI and NBI, and had the results consistent with histopathological findings. Conclusion pCLE can be used in the differential diagnosis of fundic gland polyps.

Keywords

• gastric polyp
• fundic gland polyps
• probe-based confocal laser endomicroscopy