scholarly journals Utilizing fourth-generation endocytoscopy and the ‘enlarged nuclear sign’ for in vivo diagnosis of early gastric cancer

2019 ◽  
Vol 07 (08) ◽  
pp. E1002-E1007 ◽  
Author(s):  
Mary Raina Angeli Abad ◽  
Haruhiro Inoue ◽  
Haruo Ikeda ◽  
Anastassios Manolakis ◽  
Enrique Rodriguez de Santiago ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Diagnosis ◽  
Kappa Statistic ◽  
Observer Agreement ◽  
Fourth Generation ◽  
Well Differentiated ◽  
Sensitivity Specificity

Abstract Background and study aims Fourth-generation endocytoscopy is an ultra-high magnification endoscopic technique designed to provide excellent quality in vivo histologic assessment of gastrointestinal lesions. This study aims to evaluate the diagnostic accuracy of endocytoscopy in early gastric cancer diagnosis. Patients and methods A single-center, retrospective analysis of prospectively collected data from all gastric endocytoscopic examinations was conducted. Two expert endoscopists, blinded to white-light and narrow-band imaging findings as well as histopathologic diagnosis, independently reviewed and diagnosed all endocytoscopic images. A newly recognized “enlarged nuclear sign” was detected, and its implication in early gastric cancer diagnosis was evaluated. The diagnostic performance of fourth-generation endocytoscopy was assessed while using the gold standard histopathology as a reference. Results Forty-three patients (mean age±SD, 72.6 ± 12.1 years; 31 males) were enrolled. Based on histopathology, 23 had well-differentiated adenocarcinomas, four adenomas, and 16 non-neoplastic lesions. The sensitivity, specificity, and accuracy of fourth-generation endocytoscopy for gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 80.0 % (95 % CI: 58.4 – 91.9), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist A; and 91.3 % (95 % CI: 73.2 – 97.6), 75.0 % (95 % CI: 53.1 – 88.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.71 (95 % CI: 0.50 – 0.93), was good. The sensitivity, specificity, and accuracy of the enlarged nuclear sign for early gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 95.0 % (95 % CI: 76.4 – 99.1), and 90.7 % (95 % CI: 78.4 – 96.3) by endoscopist A; and 82.6 % (95 % CI: 62.9 – 93.0), 85.0 % (95 % CI: 64.0 – 94.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.68 (95 % CI: 0.51 – 0.89) was good. Conclusion: Fourth-generation endocytoscopy appears to aid in the diagnosis of early gastric cancer, particularly well-differentiated adenocarcinomas, due to its good diagnostic accuracy and identification of the “enlarged nuclear sign,” and deserves further evaluation in future studies.

Endoscopic molecular imaging of early gastric cancer targeting transferrin receptor 1.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e23093-e23093
Author(s):  
Jie Tian ◽  
Yang Du
Keyword(s):  
Gastric Cancer ◽  
Molecular Imaging ◽  
Early Gastric Cancer ◽  
Diagnostic Accuracy ◽  
Transferrin Receptor ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Human Gastric Cancer ◽  
Transferrin Receptor 1

e23093 Background: Gastric cancer is primarily managed endoscopically by white light gastroscope with suboptimal diagnostic accuracy. Emerging optical imaging technologies possess great potential for improving diagnostic accuracy but currently lack imaging agents for molecular specificity. In this study, a novel ligand of transferrin receptor 1 (TfR1), human H-ferritin (HFn), was labeled with fluorescent agents to enable in vivo real-time imaging by confocal laser endomicroscopy (CLE). Methods: In vivo fluorescence imaging was performed in tumor-bearing mice from human gastric cancer cell lines using fluorescently labeled HFn nanoprobe. The HFn-FITC as molecular imaging agent was applied to the gastric cancer with confocal laser endomicroscopy (CLE) in fresh endoscopic submucosal dissection (ESD) of early gastric cancer. Results: Intravital imaging of gastric xenograft tumors revealed a specific tumor targeting effects of HFn-IRDye800CW, whereas no specific signal was observed in mice injected with free dye. An ex vivo experiment on human specimens using a rigid confocal probe showed positive fluorescent staining in ESD samples diagnosed as early gastric cancers. Our CLE evaluation correlated well with immunohistochemical findings. Conclusions: CLE can be used for in vivo, molecular analysis of early gastric cancer and to identify TfR1 expression in xenografts and human tissue samples. HFn-targeted molecular imaging could improve early detection of gastric cancer.

Tu1994 IN-VIVO DIAGNOSIS OF EARLY GASTRIC CANCER WITH FOURTH-GENERATION ENDOCYTOSCOPY AND THE NEWLY-RECOGNIZED "ENLARGED NUCLEAR SIGN"

2019 ◽  
Vol 89 (6) ◽  
pp. AB648-AB649
Author(s):  
Mary Raina Angeli Abad ◽  
Yuto Shimamura ◽  
Enrique Rodriguez de Santiago ◽  
Anastassios C. Manolakis ◽  
Yusuke Fujiyoshi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Fourth Generation ◽  
In Vivo Diagnosis

Endoscopic submucosal dissection by using Clutch cutter and IT knife 2 for early gastric cancer with severe submucosal fibrosis: a case report

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 17-21
Author(s):  
Nhan Le ◽  
Phuong Vien ◽  
Nghia Le
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastrointestinal Cancers ◽  
Pathological Result ◽  
Well Differentiated ◽  
Submucosal Fibrosis

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis. Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence. Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

UPDATE ON THE DIAGNOSIS AND MANAGEMENT OF EARLY GASTRIC CANCER

2015 ◽  
pp. 5-14
Author(s):  
Van Huy Tran ◽  
Quang Trung Tran
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Early Diagnosis ◽  
Cancer Diagnosis ◽  
Good Prognosis ◽  
Accurate Diagnosis ◽  
White Light Endoscopy ◽  
Key Factor ◽  
Magnified Endoscopy ◽  
Endoscopic Characteristics

The prognosis of gastric cancer depends principally upon an early diagnosis. An early and accurate diagnosis of gastric cancer needs some basic knowledges about the endoscopic characteristics of white light endoscopy, chromoendoscopy, magnified endoscopy, FICE and NBI…A strategy of screening is also a key factor for early diagnosis. The treatment of early gastric cancer by endoscopy techniques have showed more and more advantages. Beside of EMR, the technique of ESD is now applied more widely and lead to a very good prognosis and nearly a curative treatment for the patients with early gastric cancer. Key words: gastric cancer, early gastric cancer, diagnosis, endoscopy

scholarly journals Diagnostic value of macrophage inhibitory cytokine 1 as a novel prognostic biomarkers for early gastric cancer screening

2020 ◽  
Author(s):  
Xin Ge ◽  
Xiaolei Zhang ◽  
Yanling Ma ◽  
Shaohua Chen ◽  
Zhaowu Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Diagnostic Value ◽  
Low Grade ◽  
Serum Samples ◽  
Early Screening ◽  
Roc Curve Analysis

Abstract BACKGROUND Early diagnosis is very important to improve the survival rate of patients with gastric cancer, especially in asymptomatic participants. However, low sensitivity of common biomarkers has caused difficulties in early screening of gastric cancer. In this study, we explored whether MIC-1 can improve the detection rate of early gastric cancer.METHODS We screened 8,257 participants based on risk factors such as age, gender, and family history for physical examination including gastroscopy. Participant blood samples were taken for measure MIC-1, CA-199, CA72-4 and PG1/PG2 levels. The diagnostic performance of MIC-1 was assessed and compared with CA-199, CA72-4 and PG1/PG2, and its role in early gastric cancer diagnosis and the assessment of the risk of precancerous lesions have also been studied.RESULTS Based on endoscopic and histopathological findings, 55 participants had gastric cancer, 566 participants had low-grade neoplasia, 2605 participants had chronic gastritis. MIC-1 levels were significantly elevated in gastric cancer serum samples as compared to controls (p<0.001). The sensitivity of serum MIC-1 for gastric cancer diagnosis was much higher than that of CA-199 (49.1% vs. 20.0%) with similar specificities. Moreover, receiver operating characteristic (ROC) curve analysis also showed that serum MIC-1 had a better performance compared with CA-199, CA72-4 and PG1/PG2 in distinguishing early-stage gastric cancer (AUC: 72.9% vs. 69.5%, 67.5%, 44.0% respectively).CONCLUSIONS Serum MIC-1 is significantly elevated in most patients with early gastric cancer. MIC-1 can serve as a novel diagnostic marker of early gastric cancer and value the risk of gastric cancer.

scholarly journals In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy -a prospective pilot study-

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shoko Ono ◽  
Ayako Nozaki ◽  
Kana Matsuda ◽  
Emi Takakuwa ◽  
Naoya Sakamoto ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intraepithelial Neoplasia ◽  
Observer Agreement ◽  
Optical Biopsy ◽  
Link Type ◽  
Guided Biopsy ◽  
Vaginal Intraepithelial Neoplasia ◽  
High Level

Abstract Backgrouund For patients with any kind of atypical squamous intraepithelial lesion of the uterine cervix or vagina, colposcopy and punch biopsy are common procedures for histological determination following cytology. However, colposcopy-guided biopsy does not provide a high level of diagnostic accuracy. The aim of this study was to determine the usefulness of optical biopsy in vivo using endocytoscopy compared with conventional procedures using colposcopy. Methods Between May 2018 and March 2019, patients who were scheduled for cervical conization or mapping biopsies of the vagina were prospectively enrolled. Endocytoscopy was performed by senior endoscopists prior to scheduled procedures, and endocytoscopic images and biopsy samples were taken from the most prominent site and surrounding area of the cervical or vaginal lesions. The collection process of images was randomized and anonymous, and three doctors separately evaluated the images according to the ECA classification. ECA 4 and 5 are indicative of endoscopic malignancy. The primary endpoint was diagnostic accuracy (benign or malignant: cervical intraepithelial neoplasia (CIN) 3 or vaginal intraepithelial neoplasia (VAIN) 3 or worse) of cell images at the most prominent site in each patient. Results A total of 28 consecutive patients were enrolled. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endocytoscopic images were 95.0% (84.8–98.6%), 87.5% (61.9–96.5%), 95.0% (84.8–98.6%), 87.5% (61.9–96.5%) and 92.9% (78.2–98.0%), respectively. Inter-observer agreement among three reviewers was 0.78 (0.08–9.88, P < 0.01). On the other hand, the accuracy of colposcopy-guided biopsy was 74.1% (64.0–84.0%). Conclusions Optical cell diagnosis of cervical or vaginal intraepithelial neoplasia using endocytoscopy provides a high level of diagnostic accuracy. Trial registration The study was registered with the UMIN database (ID: 000031712). UMIN000031712. Registered 16 March 2017,

scholarly journals Factors Affecting the Accuracy of Endoscopic Ultrasonography in the Diagnosis of Early Gastric Cancer Invasion Depth: A Meta-analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Ding Shi ◽  
Xiao-xia Xi
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasonography ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Depth Of Invasion ◽  
Invasion Depth ◽  
Sensitivity Specificity

Background. Endoscopic ultrasonography (EUS) is the first imaging modality for investigating the depth of invasion in early gastric cancer (EGC). However, there is presently no consensus on the accuracy of EUS in diagnosing the invasion depth of EGC. Aim. This study is aimed at systematically evaluating the accuracy of EUS in diagnosing the invasion depth of EGC and its affecting factors. Methods. The literatures were identified by searching PubMed, SpringerLink, Cochrane Library, Web of Science, Nature, and Karger knowledge databases. Two researchers extracted the data from the literature and reconstructed these in 2×2 tables. The Meta-DiSc software was used to evaluate the overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic advantage ratio, and 95% confidence interval (CI). The SROC was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value. Results. A total of 17 articles were selected, which included 4525 cases of lesions. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic dominance ratio, and 95% CI of EUS for diagnosing EGC was 0.87 (95% CI: 0.86-0.88), 0.67 (95% CI: 0.65-0.70), 2.90 (95% CI: 2.25-3.75), 0.17 (95% CI: 0.13-0.23), and 18.25 (95% CI: 12.61-26.39), respectively. The overall overstaging rate of mucosa/submucosa 1 (M/SM1) and SM by EUS was 13.31% and 32.8%, respectively, while the overall understaging rate of SM was 29.7%. The total misdiagnosis rates for EUS were as follows: 30.4% for lesions≥2 cm and 20.9% for lesions<2 cm, 27.7% for ulcerative lesions and 21.4% for nonulcerative lesions, and 22% for differentiated lesions and 26.9% for undifferentiated lesions. Conclusion. EUS has a moderate diagnostic value for the depth of invasion of EGC. The shape, size, and differentiation of lesions might be the main factors that affect the accuracy of EUS in diagnosing EGC.

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