The diagnostic utility of endocytoscopy for the detection of esophageal lesions: a systematic review and meta-analysis

Objective: To systematically evaluate the value of endocytoscopy (ECS) in the diagnosis of early esophageal cancer (EC). Methods: Pubmed, Ovid and EMbase databases were searched to collect diagnostic tests of ECS assisted diagnosis of early EC. The retrieval time was from the establishment of the database to August 2022. Review manager 5.4, Stata 16.0 and Meta-Disc 1.4 were used for meta-analysis after two researchers independently screened literature, extracted data and evaluated the bias risk of included studies. Results: A total of 7 studies were included, including 520 lesions. Meta-analysis results showed that the combined sensitivity(SE), specificity(SP), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and positive posterior probability (PPP) of ECS screening for early EC were 0.95[95%CI: 0.84, 0.98], 0.92 [95%CI: 0.83, 0.96], 11.8 [95%CI: 5.3, 26.1], 0.06 [95%CI: 0.02, 0.18], 203 [95%CI: 50, 816], and 75%, respectively. The area (AUC) under the receiver Operating Characteristic curve (SROC) was 0.98[95%CI: 0.96, 0.99]. Conclusions: Current evidence suggests that ECS can be used as an effective screening tool for early EC. Due to the limited number and quality of included studies, it is imperative to conduct more high-quality studies to verify the above conclusions.