Diagnosis of undifferentiated type early gastric cancers by magnification endoscopy with narrow-band imaging

Introduction: Curative rates of endoscopic treatment for undifferentiated-type early gastric cancer (EGC), particularly mixed poorly differentiated adenocarcinoma (MIXED-POR), are lower than those of endoscopic treatment for the differentiated type. Magnifying endoscopy with narrow-band imaging (ME-NBI) is useful for diagnoses of the histological type. This study aimed to investigate the detection rates of MIXED-POR among undifferentiated-type EGCs using biopsy and ME-NBI in order to improve curative rates through endoscopic treatment. Methods: We analyzed 267 lesions initially subjected to endoscopic submucosal resection (ESD) and histologically diagnosed as undifferentiated-type EGCs between July 2005 and December 2016 at our hospital. We obtained written informed consent from all participants. Biopsy and ME-NBI findings were compared to distinguish pure signet ring cell carcinoma (PURE-SIG) and MIXED-POR. ME-NBI findings were divided into 2 categories depending on the presence of irregular vessels. Results of biopsy and ME-NBI (combination method) were also analyzed, and detection rates of MIXED-POR and PURE-SIG were evaluated in terms of sensitivity, specificity, and accuracy. Results: Overall, 114 lesions were analyzed. Fifty-eight lesions (50.9%) were identified as MIXED-POR. With biopsy, the detection rate of MIXED-POR was significantly lower than that of PURE-SIG (p < 0.0001). ME-NBI detected significantly more MIXED-POR with irregular vessels than PURE-SIG (p < 0.0001). The combination method could detect significantly more MIXED-POR than PURE-SIG (p < 0.0001). The sensitivity and accuracy for MIXED-POR diagnosis were significantly higher with the combination method than with biopsy alone (p < 0.0001). Discussion/Conclusion: Combining biopsy and ME-NBI improved the accuracy of pretreatment diagnosis before ESD in undifferentiated-type cancer.

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Sa1601 Cancer Risk Assessment System of Vascular and Surface Patterns in Gastric Lesions for Computer-Aided Pathology Prediction With High-Magnification Endoscopy (HME) and Narrow-Band Imaging (NBI)

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.652 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB264

Author(s):

Sergey V. Kashin ◽

Roman O. Kuvaev ◽

Alexander S. Nadezhin ◽

Herbert Edelsbrunner ◽

Viktor Kapranov ◽

...

Keyword(s):

Risk Assessment ◽

Narrow Band ◽

Narrow Band Imaging ◽

Assessment System ◽

Cancer Risk Assessment ◽

High Magnification ◽

Gastric Lesions ◽

Magnification Endoscopy ◽

Computer Aided ◽

Surface Patterns

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Magnification endoscopy in combination with acetic acid enhancement and narrow-band imaging for the accurate diagnosis of colonic neoplasms

Endoscopy International Open ◽

10.1055/a-1068-2056 ◽

2020 ◽

Vol 08 (04) ◽

pp. E488-E497

Author(s):

Kotaro Shibagaki ◽

Norihisa Ishimura ◽

Takafumi Yuki ◽

Hideaki Taniguchi ◽

Masahito Aimi ◽

...

Keyword(s):

Acetic Acid ◽

Diagnostic Accuracy ◽

Endoscopic Resection ◽

Narrow Band ◽

Narrow Band Imaging ◽

Colonic Neoplasms ◽

High Accuracy ◽

Colorectal Polyps ◽

Histologic Diagnosis ◽

Magnification Endoscopy

Abstract Background and study aims Magnification endoscopy with narrow-band imaging (NBIME) and NBIME with acetic acid enhancement (A-NBIME) enable visualization of the vascular and microstructural patterns of colorectal polyp. We compared the diagnostic accuracy and reproducibility of white light endoscopy (WLE), NBIME, and A-NBIME for predictive histologic diagnosis. Patients and methods Consecutive colorectal polyps (N = 628; 38 hyperplasias, 488 adenomas, 72 M-SM1 cancers, and 30 SM2 cancers) were photographed with WLE, NBIME, and A-NBIME. Endoscopic images were independently reviewed by three experts, according to the traditional criteria for WLE, the Japan NBI Expert Team classification for NBIME, and pit pattern classification for A-NBIME to compare diagnostic accuracy and interobserver diagnostic agreement among modalities. Results The specificity (95 % confidence interval) of hyperplasia and SM2 cancer with WLE were 98.2 % (96.8 %–99.1%) and 99.4 % (98.5 %–99.9 %), respectively, showing high accuracy for endoscopic resection without magnifying observation. Diagnostic accuracy of WLE, NBIME, and A-NBIME was 80.8 % (77.4 %–83.8 %), 79.3 % (75.9 %–82.4 %), and 86.1 % (83.2 %–88.7 %), respectively, showing the highest accuracy for A-NBIME among modalities (P < .05). NBIME showed a lower PPV for M-SM1 cancer (P < .05), as with WLE (P = .08) compared to A-NBIME. Fleiss’s kappa values for WLE, NBIME, and A-NBIME diagnosis were 0.43 (0.39 – 0.46), 0.52 (0.49 – 0.56) and 0.65 (0.62 – 0.69), respectively, showing insufficient reproducibility of WLE and superiority of A-NBIME among modalities. Conclusion WLE showed high accuracy for endoscopic resection of colorectal polyps in expert diagnosis. NBIME demonstrated a higher diagnostic reproducibility than WLE. A-NBIME showed possible superiority among modalities in both diagnostic accuracy and reproducibility.

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