Journal
JOURNAL OF CLINICAL LABORATORY ANALYSIS
Volume 36, Issue 1, Pages -Publisher
WILEY
DOI: 10.1002/jcla.24122
Keywords
artificial intelligence; endoscopy; DNA methylation; gastric indefinite dysplasia; gastric cancer; endoscopy; molecular markers
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Funding
- Ministry of Education, Culture, Sports, Science and Technology of Japan [18K15764, 19H03521, 19H03568, 21K07901]
- New Energy and Industrial Technology Development Organization [19194859]
- Grants-in-Aid for Scientific Research [21K07901, 19H03521, 19H03568, 18K15764] Funding Source: KAKEN
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The study compared the accuracy of physician-performed endoscopy, artificial intelligence, and/or molecular markers in diagnosing GIN lesions, with board-certified endoscopic physicians group showing the highest accuracy, followed by a combination of AI and miR148a DNA methylation, and trainee endoscopists group having the lowest accuracy.
Background and Aim Gastrointestinal endoscopy and biopsy-based pathological findings are needed to diagnose early gastric cancer. However, the information of biopsy specimen is limited because of the topical procedure; therefore, pathology doctors sometimes diagnose as gastric indefinite for dysplasia (GIN). Methods We compared the accuracy of physician-performed endoscopy (trainee, n = 3; specialists, n = 3), artificial intelligence (AI)-based endoscopy, and/or molecular markers (DNA methylation: BARHL2, MINT31, TET1, miR-148a, miR-124a-3, NKX6-1; mutations: TP53; and microsatellite instability) in diagnosing GIN lesions. We enrolled 24,388 patients who underwent endoscopy, and 71 patients were diagnosed with GIN lesions. Thirty-two cases of endoscopic submucosal dissection (ESD) in 71 GIN lesions and 32 endoscopically resected tissues were assessed by endoscopists, AI, and molecular markers to identify benign or malignant lesions. Results The board-certified endoscopic physicians group showed the highest accuracy in the receiver operative characteristic curve (area under the curve [AUC]: 0.931), followed by a combination of AI and miR148a DNA methylation (AUC: 0.825), and finally trainee endoscopists (AUC: 0.588). Conclusion AI with miR148s DNA methylation-based diagnosis is a potential modality for diagnosing GIN.
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