• Mélissa Gruner, Angélique Denis, Claude Masliah, Morgane Amil, Elodie Metivier-Cesbron, Dominique Luet, Medhi Kaasis, Emmanuel Coron, Marc Le Rhun, Stéphane Lecleire, Michel Antonietti, Jean-Louis Legoux, Laurent Lefrou, Pascal Renkes, Anne-Laure Tarreirias, Philippe Balian, Philippe Rey, Bénédicte Prost, Christophe Cellier, Gabriel Rahmi, Elia Samaha, Serge Fratte, Béatrice Guerrier, Verena Landel, Sandrine Touzet, Thierry Ponchon, and Mathieu Pioche.
• Gastroenterology Division, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
• Endoscopy. 2021 Jul 1; 53 (7): 674-682.

BackgroundNarrow-band imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect esophageal squamous cell carcinoma (SCC) but its specificity, which appears higher than that of Lugol chromoendoscopy in expert centers, remains to be established in general practice. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy in the detection of esophageal SCC and high grade dysplasia (HGD) in current general practice (including tertiary care centers, local hospitals, and private clinics).MethodsThis prospective randomized multicenter trial included consecutive patients with previous or current SCC of the upper aerodigestive tract who were scheduled for gastroscopy. Patients were randomly allocated to either the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, NBI examination was performed after white-light endoscopy. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis.Results334 patients with history of SCC were included and analyzed (intention-to-treat) from 15 French institutions between March 2011 and December 2015. In per-patient analysis, sensitivity, specificity, positive and negative likelihood values were 100 %, 66.0 %, 21.2 %, and 100 %, respectively, for Lugol chromoendoscopy vs. 100 %, 79.9 %, 37.5 %, and 100 %, respectively, for NBI. Specificity was greater with NBI than with Lugol (P = 0.002).ConclusionsAs previously demonstrated in expert centers, NBI was more specific than Lugol in current gastroenterology practice for the detection of early SCC, but combined approaches with both NBI and Lugol could improve the detection of squamous neoplasia.Thieme. All rights reserved.

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