Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions

详细信息    查看全文

• 作者：Shinichiro Maki (1)
  Kenshi Yao (2)
  Takashi Nagahama (1)
  Takahiro Beppu (1)
  Takashi Hisabe (1)
  Yasuhiro Takaki (1)
  Fumihito Hirai (1)
  Toshiyuki Matsui (1)
  Hiroshi Tanabe (3)
  Akinori Iwashita (3)
  
• 关键词：Magnifying endoscopy ; Narrow ; band imaging ; Superficial elevated lesions ; Gastric adenoma ; Early gastric cancer
• 刊名：Gastric Cancer
• 出版年：2013
• 出版时间：April 2013
• 年：2013
• 卷：16
• 期：2
• 页码：140-146
• 全文大小：743 KB
• 参考文献：1. Hamada T, Kondou K, Simoya M, et al. Clinical management to gastric flat elevated lesion. Stomach Intest. 1999;34:1513-0. (in Japanese with English abstract).
  2. Nakamura S, Matsumoto T, Ishikawa T, et al. Long term clinical course of gastric adenoma: a retrospective analysis of tumors with enlargement and those with malignant transformation. Stomach Intest. 2003;38:1389-00. (in Japanese with English abstract).
  3. Toyozumi H, Tajiri H. Magnifying endoscopy diagnosis for elevated early gastric cancer and adenoma. Stomach Intest. 2011;46:853-5. (in Japanese with English abstract).
  4. Motohiko K, Tsutomu N, Shusaku T, et al. Endoscopic submucosal dissection as a treatment for gastric noninvasive neoplasia: a multicenter study by Osaka University ESD study group. J Gastroenterol. 2011;46:325-1. CrossRef
  5. Takemura S, Iwashita A, Yao K, et al. The correlation between the quantified microvascular density and the endoscopic color in elevated type of gastric neoplastic lesions. Gastroenterol Endosc. 2002;44:745-4. (in Japanese with English abstract).
  6. Yao K, Oishi T. Microgastroscopic findings of mucosal microvascular architecture as visualized by magnifying endoscopy. Dig Endosc. 2001;13:S27-3. CrossRef
  7. Yao K, Yao T, Iwashita A. Determining the horizontal extent of early gastric carcinoma: two modern techniques based on differences in the mucosal microvascular architecture and density between carcinomatous and non carcinomatous mucosa. Dig Endosc. 2007;14:S83-. CrossRef
  8. Yao K, Oishi T, Matsui T, et al. Novel magnified endoscopic findings of microvascular architecture in intramucosal gastric cancer. Gastrointest Endosc. 2002;56:279-4. CrossRef
  9. Yao K, Iwashita A, Matsui T, et al. Microvascular architecture in gastric flat reddened lesions visualized by magnified endoscopy: usefulness for differentiating between gastritis and gastric cancer. Gastrointest Endosc. 2003;57:AB156.
  10. Yao K, Kikuchi Y, Tanabe H, et al. Novel zoom-endoscopy technique for visualizing the microvascular architecture of early gastric cancer enables the precise margin of the cancer to be determined thereby allowing successful resection by the endoscopic submucosal dissection method. Endoscopy. 2004;36:A6.
  11. Yao K, Iwashita A, Tao T. Early gastric cancer: proposal for a new diagnostic system based on micro vascular architecture as visualized by magnified endoscopy. Dig Endosc. 2004;16:S110-. CrossRef
  12. Yao K, Iwashita A, Kikuchi Y, et al. Novel zoom endoscopy technique for visualizing the microvascular architecture in gastric mucosa. Clin Gastroenterol Hepatol. 2005;3:S23-. CrossRef
  13. Yao K, Iwashita A, Tanabe H, et al. Novel zoom endoscopy technique for diagnosis of small flat gastric cancer: a prospective, blind study. Clin Gastroenterol Hepatol. 2007;5:869-8. CrossRef
  14. Yao K, Takaki Y, Matsui T, et al. Clinical application of magnification endoscopy and narrow-band imaging in the upper gastrointestinal tract: new imaging techniques for detecting and characterizing gastrointestinal neoplasia. Gastrointest Endosc Clin N Am. 2008;18:415-3. CrossRef
  15. Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy. 2009;41:462-. CrossRef
  16. Yao K, Iwashita A, Matsui T. A new diagnostic classification system by magnification endoscopy and narrow-band imaging in the stomach: microvascular architecture and microsurface structure. In: Niwa H, Tajiri H, Nakajima M, et al., editors. New challenges in gastrointestinal endoscopy. Heidelberg: Springer; 2008. p. 169-6.
  17. Anagnostopoulos GK, Yao K, Kaye P, et al. Novel endoscopic observation in Barrett’s oesophagus using high resolution magnification endoscopy and narrow band imaging. Gut. 2006;55:A105. CrossRef
  18. Yao K, Nagahama T, Hirai F, et al. Clinical application of magnification endoscopy with NBI in the stomach and the duodenum. In: Cohen J, editor. Comprehensive atlas of high resolution endoscopy and narrow band imaging. Oxford: Blackwell; 2007. p. 169-76.
  19. Yao K, Iwashita A, et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc. 2008;68:574-. CrossRef
  20. Schlemper RJ, Riddell RH, Borchard F, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251-. CrossRef
  21. Nagahama T, Yao K, Maki S, et al. Usefulness of magnifying endoscopy with narrow-band imaging for determining the horizontal extent of early gastric cancer when there is an unclear margin by chromoendoscopy (with video). Gastrointest Endosc. 2011;74:1259-7. CrossRef
  22. Ezoe Y, Muto M, Uedo N, et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology. 2011;141:2017-5. CrossRef
  23. Yao K, Yao T, Matsui T, et al. Hemoglobin content in intramucosal gastric carcinoma as a marker of histological differentiation: a clinical application of quantitative electronic endoscopy. Gastrointest Endosc. 2000;52:241-. CrossRef
  
• 作者单位：Shinichiro Maki (1)
  Kenshi Yao (2)
  Takashi Nagahama (1)
  Takahiro Beppu (1)
  Takashi Hisabe (1)
  Yasuhiro Takaki (1)
  Fumihito Hirai (1)
  Toshiyuki Matsui (1)
  Hiroshi Tanabe (3)
  Akinori Iwashita (3)
  
  1. Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
  2. Department of Endoscopy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan
  3. Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan
  
• ISSN：1436-3305

文摘

Background The usefulness of magnifying gastroscopy has been reported in differentiating between benign and malignant gastric mucosal lesions. However, there have been no studies of the usefulness of magnifying endoscopy with narrow-band imaging (M-NBI) in the diagnosis of superficial (non-polypoid) elevated lesions of the stomach. In this study, we investigated the ability of M-NBI to differentiate between cancer and adenoma in superficial elevated lesions of the stomach. Methods We examined 93 consecutive superficial elevated lesions of the stomach. We defined the endoscopic criteria for early cancer as red coloring using conventional white light imaging (C-WLI), and an irregular microvascular pattern with a demarcation line, or irregular microsurface pattern with a demarcation line, using M-NBI. We determined the sensitivity, specificity and accuracy of C-WLI and M-NBI in the diagnosis of these 93 lesions. Results The sensitivity, specificity, and accuracy (95?% confidence interval) of C-WLI versus M-NBI were 64?% (52-6?%) versus 95?% (90-00?%), 94?% (86-00?%) versus 88?% (77-9?%), and 74?% (66-3?%) versus 92?% (86-8?%), respectively. Sensitivity and accuracy were significantly higher for M-NBI than C-WLI. Conclusions M-NBI appears to be useful in differentiating between cancerous and adenomatous superficial elevated lesions of the stomach.