Predicting Clinical Outcomes Of Early Gastric Cancer:a Comparison Of White-light Endoscopy And Magnifying Endoscopy With Blue Laser Imaging:a Single-center Retrospective Cohort Study

Background and Aims: With the advancement of endoscopic examination,early gastric cancer is increasingly found and treated by endoscopic resection.We aimed to evaluate the common white-endoscopy and blue laser imaging features of endoscopy for early gastric cancer.Methods: In total,103 gastric lesions from 97 consecutive patients who presented between January 2015 and September 2017 and underwent white-light endoscopic examination and magnifying endoscopic with blue laser imaging(MEBLI)were retrospectively studied.These patients were treated with endoscopic submucosal dissection(ESD).The white-light endoscopic/MEBLI parameters were analyzed.The revised Vienna classification system was used for histological diagnosis.Results: The concordance rate between conventional forceps biopsy(CFB)and ESD specimens was 42.7%(44/103).En bloc resection and complete resection rates were 93.2%(96/103)and 87.4%(90/103),respectively.In the univariate analysis,location,gross type,the presence of erosion,erythema,the presence of ulcer or ulcer scar,and positive MEBLI findings were risk factors for the prediction of early gastric cancer.Among these factors,the presence of erythema and positive MEBLI findings were considered to be more significant according to the multivariate analysis(P = 0.004 and <0.001 respectively).Positive MEBLI demonstrated the most powerful predictive value,with a multivariate adjusted odds ratio of 21.24(95% CI 4.28–105.28).Conclusions: MEBLI can provide more accurate information than white-light endoscopy for the prediction of early gastric cancer.ESD is strongly used in cases with surface erythema on conventional white-light endoscopy or positive MEBLI findings.