scholarly journals Additive Effects of Evaluating Micro-Surface and Microvascular Patterns Using Magnifying Endoscopy with Narrow-Band Imaging for Gastric Cancer

2021 ◽  
Author(s):  
Yusuke Horiuchi ◽  
Toshiaki Hirasawa ◽  
Naoki Ishizuka ◽  
Junki Tokura ◽  
Mitsuaki Ishioka ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Evaluation Method ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Additive Effects ◽  
Surface Patterns ◽  
Microvascular Pattern

Abstract No studies have compared the performance of microvascular and micro-surface patterns alone with their combination in magnifying endoscopy with narrow-band imaging for diagnosing gastric cancer. This study aimed to clarify the difference in diagnostic performance between these methods. Thirty-three participating endoscopists underwent specialized training in magnifying endoscopy evaluated microvascular and micro-surface patterns for images of 106 cancerous and 106 non-cancerous cases. If classified as “irregular”, the lesion was diagnosed as cancerous. To evaluate diagnostic performance, we compared the diagnostic accuracy, sensitivity, and specificity among the methods. Performance-related items did not significantly differ between the microvascular and micro-surface patterns. However, the diagnostic accuracy and sensitivity were significantly higher when using the combination of these methods than when using the microvascular pattern alone (percentage [95% confidence interval]: 82.1% [76.4–86.7] vs. 76.4% [70.3–81.6], P = 0.0005; and 69.8% [60.5–77.8] vs. 63.2% [53.7–71.8], P = 0.0082, respectively). The additive effects on diagnostic accuracy and sensitivity were 5.7% and 6.6%, respectively. The combination of micro-surface and microvascular patterns has superior diagnostic accuracy and sensitivity for diagnosing gastric cancer than the evaluation method using microvascular pattern alone. Our results may contribute to improving the diagnosis of gastric cancers.

scholarly journals Differences in the Microsurface and Microvascular Features between Early Gastric Cancer of Corpus and Antrum under Narrow Band Imaging Magnifying Endoscopy

2019 ◽  
Author(s):  
Qian Zhuang ◽  
Jing Wang ◽  
Shengzheng Luo ◽  
Xiaowan Wu ◽  
Jinnian Cheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Tumor Location ◽  
Magnifying Endoscopy ◽  
Histologic Type ◽  
Invasion Depth ◽  
Macroscopic Shape ◽  
Microvascular Pattern

Abstract Objectives Microsurface structure (MS) and microvascular features (MV) of early gastric cancer (EGC) are associated with the histologic type, invasion depth and macroscopic shape of lesions. However, no studies have reported the differences in the MS and MV features between EGCs of antrum and corpus under magnifying endoscopy with narrow band imaging (ME-NBI).Methods This is a retrospective study including 116 patients with EGC. The characteristics of MS and MV pattern of EGC were evaluated in 2 group, antrum type and corpus type.Results According to the Sakaki’s classification, the MS of EGCs presented as IV, V1 or VI typein in sequence, one level higher than the previous type in the degree of atypia. Tumor location and differentiated degree were identified as independent predictors for MS pattern. For the probability of at least one level higher, in the MS pattern, the corporal EGCs was 5.84 times as high as that of antral EGCs ( χ 2 =9.42, P=0.002, 95%CI 1.89-18.05), and undifferentiated-type lesions was 8.82 times as high as that of the differentiated-type lesions ( χ 2 =11.67, P=0.001, 95%CI 2.53-30.76). No difference in the MV pattern was observed between antral EGCs and corporal EGCs (P=0.7), while the microvascular pattern and microsurface pattern (VS pattern, FNP, ILL-1, ILL-2 and CSP) were significantly different between those 2 groups (P=0.001).Conclusions There are significant differences in the MS and VS pattern of EGC between antrum and corpus types. The antral EGC is less obvious than the corporal EGC, therefore, it is more likely to be missed in clinical gastroscopy.

scholarly journals Multicenter prospective study on the histological diagnosis of gastric cancer by narrow band imaging-magnified endoscopy with and without acetic acid

2019 ◽  
Vol 07 (02) ◽  
pp. E155-E163 ◽  
Author(s):  
Takaaki Kishino ◽  
Tsuneo Oyama ◽  
Keita Funakawa ◽  
Eiji Ishii ◽  
Tetsuro Yamazato ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Diagnostic Accuracy ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Histological Type ◽  
Surface Pattern ◽  
Pit Pattern ◽  
Undifferentiated Adenocarcinoma ◽  
Surface Patterns ◽  
Magnified Endoscopy

Abstract Background and study aims The usefulness of endoscopy for diagnosing histological type remains unclear. This study aimed to examine the diagnostic accuracy of white light endoscopy (WLE), magnified endoscopy with narrow band imaging (NBI-ME), and NBI-ME with acetic acid enhancement (NBI-AA) for histological type of gastric cancer. Patients and methods Patients with depressed-type gastric cancers resected by endoscopic submucosal dissection were prospectively enrolled, and 221 cases were analyzed. Histological type was diagnosed by WLE, followed by NBI-ME and NBI-AA. Histological type was classified into differentiated adenocarcinoma and undifferentiated adenocarcinoma. Histological type was diagnosed based on lesion color in WLE, surface patterns (pit, villi, and unclear) and vascular irregularities in NBI-ME, and surface patterns in NBI-AA. Results Histological types of target areas were differentiated adenocarcinoma and undifferentiated adenocarcinoma in 206 and 15 cases, respectively. Diagnostic accuracy of WLE, NBI-ME, and NBI-AA for the histological type was 96.4 % (213/221), 96.8 % (214/221), and 95.5 % (211/221), respectively. No significant differences were observed among modalities. Positive predictive value based on endoscopic findings in NBI-ME was 98.0 % (149/152) for the villi pattern, 100 % (19/19) for the irregular pit pattern, 100 % (9/9) for the unclear surface pattern with a vascular network, 90.3 % (28/31) for the unclear surface pattern with mild vascular irregularity, and 88.9 % (8/9) for the unclear surface pattern with severe vascular irregularity. Conclusions NBI-ME and NBI-AA did not show any advantages over WLE for diagnostic accuracy. Villi pattern, irregular pit pattern, and vascular network may be useful for identifying differentiated adenocarcinoma.

scholarly journals Differences in the Microsurface and Microvascular Features between Early Gastric Cancer of Corpus and Antrum under Narrow Band Imaging Magnifying Endoscopy

2019 ◽  
Author(s):  
Qian Zhuang ◽  
Jing Wang ◽  
Shengzheng Luo ◽  
Xiaowan Wu ◽  
Jinnian Cheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Tumor Location ◽  
Magnifying Endoscopy ◽  
Histologic Type ◽  
Invasion Depth ◽  
Macroscopic Shape ◽  
Microvascular Pattern

Abstract Background Microsurface structure (MS) and microvascular features (MV) of early gastric cancer (EGC) are associated with the histologic type, invasion depth and macroscopic shape of lesions. However, no studies have reported the differences in the MS and MV features between EGCs of antrum and corpus under magnifying endoscopy with narrow band imaging (ME-NBI).Methods This was a retrospective study including 116 patients with EGC. The characteristics of MS and MV pattern of EGC were evaluated in 2 group, antrum type and corpus type.Results According to the Sakaki’s classification, the MS of EGCs presented as IV, V1 or VI typein in sequence, one level higher than the previous type in the degree of atypia. Tumor location and differentiated degree were identified as independent predictors for MS pattern. For the probability of at least one level higher, in the MS pattern, the corporal EGCs was 5.84 times as high as that of antral EGCs ( χ 2 =9.42, P=0.002, 95%CI 1.89-18.05), and undifferentiated-type lesions was 8.82 times as high as that of the differentiated-type lesions ( χ 2 =11.67, P=0.001, 95%CI 2.53-30.76). No difference in the MV pattern was observed between antral EGCs and corporal EGCs (P=0.7), while the microvascular pattern and microsurface pattern (VS pattern, FNP, ILL-1, ILL-2 and CSP) were significantly different between those 2 groups (P=0.001).Conclusions There are significant differences in the MS and VS pattern of EGC between antrum and corpus types. The antral EGC is less obvious than the corporal EGC, therefore, it is more likely to be missed in clinical gastroscopy.

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.

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