Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging

Hiroki Nakamura; Shin-ei Kudo; Masashi Misawa; Shinichi Kataoka; Kunihiko Wakamura; Takemasa Hayashi; Toyoki Kudo; Yuichi Mori; Kenichi Takeda; Katsuro Ichimasa; Hideyuki Miyachi; Atushi Katagiri; Fumio Ishida; Haruhiro Inoue

doi:10.1055/s-0042-117629

Endoscopy International Open, Inhaltsverzeichnis

Endosc Int Open 2016; 04(12): E1280-E1285
DOI: 10.1055/s-0042-117629

Original article

Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging

Hiroki Nakamura

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Shin-ei Kudo

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Masashi Misawa

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Shinichi Kataoka

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Kunihiko Wakamura

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Takemasa Hayashi

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Toyoki Kudo

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Yuichi Mori

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Kenichi Takeda

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Katsuro Ichimasa

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Hideyuki Miyachi

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Atushi Katagiri

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Fumio Ishida

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Haruhiro Inoue

²Digestive Disease Center, Showa University, Koto-Toyosu Hospital, Tokyo, Japan

› Institutsangaben

Abstract

Background and study aims: Magnifying narrow-band imaging (NBI) is useful for examination of colorectal lesions, and endocytoscopy (EC) allows diagnostic evaluation of structural atypia, nuclear atypia, and vascular structures of colorectal tumors. The aim of this study was to examine surface microvessels in deep invasive colorectal cancer using EC with a new NBI video processor system.

Patients and methods: We retrospectively assessed 132 colorectal neoplastic lesions: 81 adenomas, 18 intramucosal cancers, 4 submucosal slightly invasive cancers, and 29 submucosal deep invasive cancers. Detailed vascular findings commonly seen in submucosal deep invasive carcinomas included > 2-fold vasodilatation seen in adenomas, abnormal tortuosity and branching, loss of the micro-network pattern, caliber change in > 2 places in a single blood vessel, and blood vessels not visible in a line because they appear like a string of beads (beaded sign).

Results: Univariate analysis revealed 4 vascular findings that were strongly predictive of submucosal deep invasion: vasodilatation (odds ratio [OR] 9.31; 95 % confidence interval [CI] 3.57 – 24.30), loss of the micro-network pattern (OR 61.60; 95 % CI 17.87 – 212.29), caliber change (OR 35.7; 95 % CI 9.16 – 139.14), and the beaded sign (OR 45.90; 95 % CI 5.50 – 382.73).

Conclusions: Detailed assessment of ultra-magnified microvessels could improve the diagnostic performance for submucosal deep invasive cancer.

Study registration: UMIN-CTR000014033

Volltext

Referenzen

References
1 Kudo S, Hirota S, Nakajima T et al. Colorectal tumours and pit pattern. J Clin Pathol 1994; 47: 880-885
2 Gono K, Obi T, Yamaguchi M et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed 2004; 9: 568-577
3 Haruhiro I, Kudo S-E, Shiokawa A et al. Observation of Living Cancer Cells in the Gastrointestinal Tract. Clin Gastroenterol Hepatol 2005; 3565: 61-63
4 Kudo SE, Wakamura K, Ikehara N et al. Diagnosis of colorectal lesions with a novel endocytoscopic classification a pilot study. Endoscopy 2011; 43: 869-875
5 Mori Y, Kudo S, Ikehara N et al. Comprehensive diagnostic ability of endocytoscopy compared with biopsy for colorectal neoplasms: A prospective randomized noninferiority trial. Endoscopy 2013; 45: 98-105
6 Sano Y, Horimatsu T, Fu KI et al. Magnifying observation of microvascular architecture of colorectal lesions using a narrow-band imaging system. Dig Endosc 2006; 18: 44-51
7 Katagiri A, Fu KI, Sano Y et al. Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia. Aliment Pharmacol Ther 2008; 27: 1269-1274
8 Hirata M, Tanaka S, Oka S et al. Magnifying endoscopy with narrow band imaging for diagnosis of colorectal tumors. Gastrointest Endosc 2007; 65: 988-995
9 Wada Y, Kudo SE, Kashida H et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastrointest Endosc American Society for Gastrointestinal Endoscopy 2009; 70: 522-531
10 Kudo S, Misawa M, Wada Y et al. Endocytoscopic microvasculature evaluation is a reliable new diagnostic method for colorectal lesions. Gastrointest Endosc 2015; 82: 1-12
11 Takeda K, Kudo SE, Misawa M et al. Comparison of the endocytoscopic and clinico-pathologic features of colorectal neoplasms. EIO 2016; 04: 397-402
12 Yagi K, Nozawa Y, Endou S et al. Diagnosis of early gastric cancer by magnifying endoscopy with NBI from viewpoint of histological imaging: Mucosal patterning in terms of white zone visibility and its relationship to histology. Diagn Ther Endosc 2012; 954809: 1-7
13 Watanabe T, Itabashi M, Shimada Y et al., Japanese Society for Cancer of the Colon and Rectum. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer.
14 Konerding M, Fait E, Gaumann A. 3D microvascular architecture of pre-cancerous lesions and invasive carcinomas of the colon. Br J Cancer 2001; 84: 1354-1362
15 Skinner SA, Frydman GM, O’Brien PE. Microvascular structure of benign and malignant tumors of the colon in humans. Dig Dis Sci 1995; 40: 373-384
16 Sasajima K, Kudo SE, Inoue H et al. Real-time in vivo virtual histology of colorectal lesions when using the endocytoscopy system. Gastrointest Endosc 2006; 63: 1010-1017
17 Ichimasa K, Kudo SE, Mori Y et al. Double staining with crystal violet and methylene blue is appropriate for colonic endocytoscopy: An in vivo prospective pilot study. Dig Endosc 2014; 26: 403-408
18 Misawa M, Kudo S, Mori Y et al. Characterization of Colorectal Lesions Using a Computer-Aided Diagnostic System for Narrow-Band Imaging Endocytoscopy. Gastroenterology 2016; 150: 1531-1532
19 Goel S, Duda DG, Xu L et al. Normalization of the Vasculature for Treatment of Cancer and Other Diseases. Physiol Rev 2011; 91: 1071-1121
20 Jain RK. Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science 2005; 307: 58-62