Comparison of the Sensitivity of pCLE and Pathological Biopsy for Gastric Mucosal Lesions (pCLE)

March 29, 2026 updated by: Zhaoshen Li, Changhai Hospital

Comparison of the Sensitivity of Probe-Based Confocal Laser Endomicroscopy and Pathological Biopsy for Gastric Mucosal Lesions

The pathological biopsy of gastric lesions, performed prior to endoscopic submucosal dissection (ESD), is crucial for differentiating the pathological nature of the lesions and guiding treatment decisions. However, due to the impact of biopsy sampling, the sensitivity of the pathological biopsy is not optimal.

The probe - based confocal laser endomicroscopy (pCLE) technique enables the real - time display of high-resolution microscopic images of the mucosal layer (with an amplification factor of up to 1000 times) through a slender optical fiber probe that can pass through the standard endoscope's working channel. It is an optical biopsy technique and has unique value in determining the pathological nature of gastric lesions.

As the Digestive Endoscopy Center of Shanghai Changhai Hospital is a national-level pCLE application demonstration center, it has prospectively collected numerous cases of pCLE examinations of gastric mucosal lesions.

The main purpose of this study is to retrospectively analyze these cases and compare the sensitivity and specificity of pathological biopsy and pCLE in differentiating the pathological nature of gastric mucosal lesions.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

In this study, the pathological results of ESD or surgical resection of large specimens were used as the gold standard. The sensitivity of preoperative confocal endomicroscopy examination and pathological biopsy for gastric mucosal cancerous lesions was compared. The study adopted a retrospective approach and invited three experts to conduct offline blind diagnoses of the confocal endoscopy images respectively. First, two experts independently diagnosed all the cases. For those cases with inconsistent diagnosis results, a third expert was then consulted for a final determination. Although it was a retrospective study, the cases included in the research were all prospectively and continuously included in a demonstration project.

Study Type

Observational

Enrollment (Estimated)

169

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • China
      • Shanghai, China
        • The First Affiliated Hospital of Naval Medical University
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population primarily consisted of patients who had undergone both preoperative pathological biopsy and pCLE examination and then received endoscopic submucosal dissection (ESD) treatment. As both pathological biopsy and pCLE struggle to achieve a perfect diagnosis, this study employed the pathological diagnosis obtained via ESD surgery as the gold standard to compare the sensitivity, specificity, and accuracy of pathological biopsy and pCLE in diagnosing early gastric cancer.

Description

Inclusion Criteria:

  • All patients aged 18-75 who underwent pCLE examination and received ESD treatmen.

Exclusion Criteria:

  • lack of pre-ESD pathological biopsy results, and ESD pathology indicated advanced gastric cancer.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sensitivity
Time Frame: The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.
Sensitivity, also known as True Positive Rate (TPR), refers to the proportion of patients with early gastric cancer that can be correctly identified by a certain diagnostic technique. High sensitivity means that this detection method can minimize the risk of missed diagnoses to the greatest extent and is applicable for disease screening (such as infectious diseases and early cancer screening).
The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Specificity
Time Frame: The pathological results can be obtained within 10 working days after ESD treatment, which can be used for specific calculations.
Specificity refers to the ability of a diagnostic test to accurately identify individuals without early gastric cancer (true negative, TN), namely, the proportion of individuals who are actually healthy and test negative.
The pathological results can be obtained within 10 working days after ESD treatment, which can be used for specific calculations.
Accuracy
Time Frame: The pathological results can be obtained within 10 working days after ESD treatment, which can be used for the calculation of accuracy.
Accuracy refers to a comprehensive indicator that measures the ability of a medical test or diagnostic method to correctly distinguish between early gastric cancer and non - cancerous lesions. It is the ratio of the sum of true positives and true negatives to the total test population.
The pathological results can be obtained within 10 working days after ESD treatment, which can be used for the calculation of accuracy.
Positive Predictive Value (PPV)
Time Frame: The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.
PPV is an important indicator in diagnostic tests, used to assess the probability that a subject actually has early gastric cancer when the test result is positive. Here is a detailed explanation.
The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.
Nnegative predictive value (NPV)
Time Frame: The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.
The definition of NPV is the probability that a lesion diagnosed as a non-cancerous lesion is actually non-cancerous.
The pathological results can be obtained within 10 working days after ESD treatment, which can be used for sensitivity calculation.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Changhai Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 30, 2026

Primary Completion (Estimated)

April 10, 2026

Study Completion (Estimated)

April 15, 2026

Study Registration Dates

First Submitted

January 27, 2026

First Submitted That Met QC Criteria

March 29, 2026

First Posted (Actual)

April 2, 2026

Study Record Updates

Last Update Posted (Actual)

April 2, 2026

Last Update Submitted That Met QC Criteria

March 29, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • pCLE vs. Pathological Biopsy

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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