Diagnostic value of autofluorescence imaging combined with narrow band imaging in intraepithelial neoplasia of Barrett's esophagus

Purpose: To evaluate the diagnostic values of Auto Fluorescence Imaging (AFI) combined with Narrow Band Imaging (NBI) in the diagnosis of the intraepithelial neoplasia of Barrett's esophagus (BE). Methods: Seventy four suspicious BE intraepithelial lesions were assessed in 50 patients by AFI who were further subjected to NBI mode to observe the changes of gastric mucosal capillaries and gastric pits. The corresponding lesions were biopsied for pathological examination. Results: Among the 74 AFI-diagnosed cases of suspicious lesions, 44 (59.5%) were high-grade intraepithelial neoplasias (BE HGIN), while the remaining 30 cases (40.5%) were false-positive. The NBI-diagnostic results of these 44 BE HGIN lesions were as follows: 39 cases were confirmed and 5 were suspicious; among the 30 false-positive BE HGIN cases, NBI gave 7 false-positive cases. The false-positive rates decreased from 40.5% of AFI to 9.5% (7/74) of NBI-AFI (p<0.05). The positive predictive value of AFI in BE HGIN was 59.5% (44/74), while that of AFI-NBI combination was 84.8% (39/46; p<0.05). Conclusions: The AFI-NBI combination technology could significantly improve (p<0.05) the detection rate of BE HGIN.