| 3 | Poor agreement between endoscopists and gastrointestinal pathologists for the interpretation of probe-based confocal laser endomicroscopy findings显示文摘AIM:To compare the interpretation of probe-based confocal laser endomicroscopy(p CLE)findings between endoscopists and gastrointestinal(GI)-pathologists.METHODS:All p CLE procedures were undertaken and the endoscopist rendered assessment.The same p CLE videos were then viewed offline by an expert GI pathologist.Histopathology was considered the gold standard for definitive diagnosis.The sensitivity,specificity and accuracy for diagnosis of dysplastic/neoplastic GI lesions and interobserver agreement between endoscopists and experienced gastrointestinal pathologist for p CLE findings were analyzed.RESULTS:Of the 66 included patients,40(60.6%)had lesions in the esophagus,7(10.6%)in the stomach,15(22.7%)in the biliary tract,3(4.5%)in the ampulla and 1(1.5%)in the colon.The overall sensitivity,specificity and accuracy for diagnosing dysplastic/neoplastic lesions using p CLE were higher for endoscopists than pathologist at 87.0%vs 69.6%,80.0%vs 40.0%and 84.8%vs 60.6%(P=0.0003),respectively.Area under the ROC curve(AUC)was greater for endoscopists than the pathologist(0.83 vs 0.55,P=0.0001).Overall agreement between endoscopists and pathologist was moderate for all GI lesions(K=0.43;95%CI:0.26-0.61),luminal lesions(K=0.40;95%CI:0.20-0.60)and those of dysplastic/neoplastic pathology(K=0.55;95%CI:0.37-0.72),the agreement was poor for benign(K=0.13;95%CI:-0.097-0.36)and pancreaticobiliary lesions(K=0.19;95%CI:-0.26-0.63).CONCLUSION:There is a wide discrepancy in the interpretation of p CLE findings between endoscopists and pathologist,particularly for benign and malignant pancreaticobiliary lesions.Further studies are needed to identify the cause of this poor agreement. | Shajan Peter Leona Council Ji Young Bang Helmut Neumann Klaus Mnkemüller Shyam Varadarajulu Charles Melbern Wilcox | 2014 | World Journal of Gastroenterology2014，20，47： | 0 |
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