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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(01): E88-E95
DOI: 10.1055/a-1723-2635
Original article

Diagnostic ability of linked color imaging in ultraslim endoscopy to identify neoplastic lesions in the upper gastrointestinal tract

Ken Haruma
 1   Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
,
Mototsugu Kato
 2   Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hokkaido, Japan
,
Kenro Kawada
 3   Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
,
Takahisa Murao
 4   Division of Gastroenterology Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan
,
Shoko Ono
 5   Division of Endoscopy, Hokkaido University Hospital, Hokkaido, Japan
,
Mitsuhiko Suehiro
 1   Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
,
Shinichiro Hori
 6   Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
,
Fumisato Sasaki
 7   Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
,
Tomoyuki Koike
 8   Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Shinji Kitamura
 9   Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
,
Osamu Dohi
10   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Hiromitsu Kanzaki
11   Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
,
Nobuaki Yagi
12   Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
,
Keiichi Hashiguchi
13   Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan
,
Shiro Oka
14   Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Kazuhiro Katada
15   Department of Gastroenterology and Hepatology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Ryo Shimoda
16   Internal Medicine and Gastrointestinal Endoscopy, Saga University, Saga, Japan
,
Kazuhiro Mizukami
17   Department of Gastroenterology, Oita University, Oita, Japan
,
Toshihisa Takeuchi
18   Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
,
Shinichi Katsuki
19   Gastroenterology, Otaru Ekisaikai Hospital, Hokkaido, Japan
,
Momoko Tsuda
 5   Division of Endoscopy, Hokkaido University Hospital, Hokkaido, Japan
,
Yuji Naito
10   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Tatsuyuki Kawano
20   Department of Surgery, Soka Municipal Hospital, Saitama, Japan
,
Keita Mori
21   Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
,
Hideki Ishikawa
22   Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Osaka, Japan
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Abstract

Background and study aims Linked color imaging (LCI) is a new image-enhancing technique that facilitates the differentiation of slight differences in mucosal color tone. We performed an exploratory analysis to evaluate the diagnostic capability of LCI in ultraslim endoscopy, using data from patients examined in the LCI-Further Improving Neoplasm Detection in upper gastrointestinal (LCI-FIND) trial, a large-scale, multicenter, randomized controlled trial that demonstrated the capability of LCI for detecting neoplastic lesions in the upper gastrointestinal tract.

Patients and methods Data from the LCI-FIND prospective trial were used. In the LCI-FIND trial, 1502 patients with a history of gastrointestinal cancer were randomly assigned to two groups based on examination methods: white light imaging (WLI) followed by LCI (WLI group) and LCI followed by WLI (LCI group). The present exploratory analysis investigated the outcomes of patients who underwent ultraslim and standard endoscopies.

Results Ultraslim endoscopes were used in 223 patients and standard endoscopes in 1279 patients. The primary endpoint of the LCI-FIND trial was the percentage of patients diagnosed with a neoplastic lesion using WLI or LCI. The corresponding percentage tended to be higher with LCI than with WLI among patients who underwent ultraslim endoscopy and among those who underwent standard endoscopy; the crude risk ratio was 2.21 [95 % confidence interval (CI): 1.06–4.67], and the adjusted odds ratio was 2.46 (95 % CI: 1.07–5.63).

Conclusions Our exploratory analysis of data from the LCI-FIND trial showed that LCI is useful in identifying neoplastic lesions, when used in ultraslim endoscopy.



Publication History

Received: 03 May 2021

Accepted after revision: 12 October 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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