Diagnostic performance of linked color imaging for gastric cancer by Helicobacter pylori infection status: A subanalysis of the large-scale, multicenter randomized controlled trial LCI-FIND

Mototsugu Kato; Shoko Ono; Kenro Kawada; Osamu Dohi; Shinji Kitamura; Tomoyuki Koike; Shinichiro Hori; Hiromitsu Kanzaki; Takahisa Murao; Nobuaki Yagi; Fumisato Sasaki; Keiichi Hashiguchi; Shiro Oka; Kazuhiro Katada; Ryo Shimoda; Kazuhiro Mizukami; Mitsuhiko Suehiro; Toshihisa Takeuchi; Shinichi Katsuki; Momoko Tsuda; Yuji Naito; Tatsuyuki Kawano; Ken Haruma; Keita Mori; Hideki Ishikawa

doi:10.1111/hel.13080

Diagnostic performance of linked color imaging for gastric cancer by Helicobacter pylori infection status: A subanalysis of the large-scale, multicenter randomized controlled trial LCI-FIND

Helicobacter. 2024 Mar-Apr;29(2):e13080. doi: 10.1111/hel.13080.

Authors

Mototsugu Kato^{1

2}, Shoko Ono³, Kenro Kawada⁴, Osamu Dohi⁵, Shinji Kitamura⁶, Tomoyuki Koike⁷, Shinichiro Hori⁸, Hiromitsu Kanzaki⁹, Takahisa Murao¹⁰, Nobuaki Yagi¹¹, Fumisato Sasaki¹², Keiichi Hashiguchi¹³, Shiro Oka¹⁴, Kazuhiro Katada¹⁵, Ryo Shimoda¹⁶, Kazuhiro Mizukami¹⁷, Mitsuhiko Suehiro¹⁸, Toshihisa Takeuchi¹⁹, Shinichi Katsuki²⁰, Momoko Tsuda^{1

2}, Yuji Naito⁵, Tatsuyuki Kawano²¹, Ken Haruma¹⁸, Keita Mori²², Hideki Ishikawa²³

Affiliations

¹ Public Interest Foundation Hokkaido Cancer Society, Sapporo, Hokkaido, Japan.
² Department of Gastroenterology, National Hospital organization Hakodate National Hospital, Hakodate, Hokkaido, Japan.
³ Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
⁴ Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
⁵ Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁶ Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
⁷ Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
⁸ Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan.
⁹ Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
¹⁰ Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
¹¹ Department of Gastroenterology, Asahi University Hospital, Gifu, Japan.
¹² Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
¹³ Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan.
¹⁴ Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan.
¹⁵ Department of Gastroenterology and Hepatology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
¹⁶ Department of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
¹⁷ Department of Gastroenterology, Oita University, Yufu, Oita, Japan.
¹⁸ Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.
¹⁹ Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
²⁰ Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Hokkaido, Japan.
²¹ Department of Surgery, Nakamura Hospital, Tokyo, Japan.
²² Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
²³ Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Osaka, Japan.

PMID: 38671594
DOI: 10.1111/hel.13080

Abstract

Background: Linked color imaging (LCI) is a new image enhancement technology that facilitates the recognition of subtle differences in mucosal color. In the large-scale, multicenter randomized controlled trial LCI-FIND, LCI demonstrated good diagnostic performance for the detection of tumor lesions in the upper gastrointestinal tract. The aim of the present study was to exploratively evaluate the diagnostic performance of LCI according to H. pylori infection status as a subanalysis of LCI-FIND trial.

Methods: The patients were randomly allocated to receive white light imaging (WLI) first, followed by LCI (WLI group), or vice versa (LCI group), and the two groups were compared for the detection of tumors. Data from this trial were analyzed by the presence/absence of H. pylori infection and further analyzed by successful or unsuccessful eradication in the H. pylori infection group.

Results: The 752 patients in the WLI group and 750 patients in the LCI group who had participated in the LCI-FIND trial were included. In the successful eradication group, more gastric lesions were detected by primary mode in the LCI group than in the WLI group, indicating that more lesions were missed by WLI. Fisher's exact probability test for the comparison of the WLI and LCI groups yielded a p-value of 0.0068, with missed gastric lesions being detected 0.136 times (95% confidence interval: 0.020-0.923), significantly less with LCI than with WLI.

Conclusion: The current study suggests that LCI should be used for gastric cancer screening, particularly in patients with successful H. pylori eradication.

Keywords: H. pylori; Image enhanced endoscopy; gastric cancer.

Publication types

Randomized Controlled Trial
Multicenter Study

MeSH terms

Adult
Aged
Color
Female
Helicobacter Infections* / diagnosis
Helicobacter pylori*
Humans
Male
Middle Aged
Stomach Neoplasms* / diagnostic imaging

Grants and funding

Fujifilm Corporation