Evaluation of confocal laser endomicroscopy for detection of occult gastric carcinoma in CDH1 variant carriers

摘要: Background Hereditary diffuse gastric cancer syndrome, attributed to inactivating germline CDH1 variants, is associated with an elevated lifetime risk of cancer. We sought evaluate detection using probe-based confocal laser endomicroscopy (pCLE) during endoscopic surveillance. Methods A prospective, single-institution study was conducted in asymptomatic adults pathogenic or likely (P/LP) variants. Subjects received surveillance pCLE conjunction the Cambridge method (CM). Abnormalities visualized by were biopsied, followed non-targeted mucosal biopsies according CM. Primary endpoint determine sensitivity for occult SRC carcinoma compared Results Thirty-six patients P/LP variants underwent endoscopy and Majority female (75%) median age 47 years. Targeted focal abnormalities on WLE negative carcinoma. Overall, 19.4% (7/36) had detected ≥1 biopsy. Non-targeted CM revealed 11.1% (4/36), whereas 16.7% (6/36). Fifteen total gastrectomy; all 15 explants contained In those patients, false-negative rates 67% 87%, respectively. Conclusions Confocal alone has low variant carriers, although it appeared no worse than current recommended required fewer per patient. more reliable needed as a viable alternative surgery this high-risk population (ClinicalTrials.gov, Number: NCT03648879).