Can we accurately diagnose minute gastric cancers (??mm)? Chromoendoscopy (CE) vs magnifying endoscopy with narrow band imaging (M-NBI)

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• 作者：Shoko Fujiwara ; Kenshi Yao ; Takashi Nagahama ; K. Uchita ; Takao Kanemitsu…
• 关键词：Chromoendoscopy ; Minute gastric cancer ; Magnifying endoscopy ; Narrow band imaging ; Image ; enhanced endoscopy
• 刊名：Gastric Cancer
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：18
• 期：3
• 页码：590-596
• 全文大小：1,577 KB
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• 作者单位：Shoko Fujiwara (1)
  Kenshi Yao (1)
  Takashi Nagahama (2)
  K. Uchita (3)
  Takao Kanemitsu (2)
  Kozue Tsurumi (4)
  Noritaka Takatsu (2)
  Takashi Hisabe (2)
  Hiroshi Tanabe (5)
  Akinori Iwashita (5)
  Toshiyuki Matsui (2)
  
  1. Department of Endoscopy, Fukuoka University Chikushi Hospital, Zokumyoin, Chikushino-shi, Fukuoka, 818-8502, Japan
  2. Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino-shi, Fukuoka, Japan
  3. Department of Internal Medicine, Kochi Red Cross Hospital, Kochi, Japan
  4. Sada Hospital, Fukuoka, Japan
  5. Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino-shi, Fukuoka, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Gastroenterology
  Surgical Oncology
  Pathology
  Radiotherapy
  
• 出版者：Springer Japan
• ISSN：1436-3305

文摘

Background Chromoendoscopy (CE) is relatively ineffective at identifying the cancer-specific morphological characteristics of minute gastric cancers less than or equal to 5?mm in diameter, and on its own is insufficient to make an accurate diagnosis. The aim of this study is to assess the diagnostic performance of magnifying endoscopy with narrow band imaging (M-NBI) for minute gastric cancers. Methods The minute cancer group comprised consecutive endoscopic submucosal dissection-resected minute gastric cancers histologically measured as no larger than 5?mm in diameter. The non-cancer group comprised consecutive non-cancer lesions no larger than 5?mm in diameter. The two groups were subject to retrospective analysis to evaluate the diagnostic ability (sensitivity, specificity, and diagnostic accuracy) and reproducibility of CE and M-NBI. Results The results for CE versus M-NBI were as follows: sensitivity 43.7?% (95?% CI, 26.5-1.0?%) versus 78.0?% (95?% CI, 64.0-2.0?%); specificity 81.6?% (95?% CI, 72.6-0.6?%) versus 92.9?% (95?% CI, 87.0-8.9?%); and diagnostic accuracy 69.9?% (95?% CI, 61.0-8.6?%) versus 88.3?% (95?% CI, 82.0-4.5?%). The sensitivity and diagnostic accuracy were, therefore, significantly higher for M-NBI than for CE. The inter-observer variability was κ?=?0.08 for CE and κ?=?0.56 for M-NBI, while the intra-observer variability was κ?=?0.38 and κ?=?0.65, respectively. Conclusions M-NBI has greater sensitivity and reproducibility than CE for the diagnosis of minute gastric cancers.