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Endosc Int Open 2016; 04(11): E1203-E1210
DOI: 10.1055/s-0042-117632
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Can magnifying endoscopy with narrow-band imaging discriminate between carcinomas and low grade adenomas in gastric superficial elevated lesions?

Takashi Nonaka
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Masahiko Inamori
2   Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
,
Yasushi Honda
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Kenji Kanoshima
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Yumi Inoh
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Mizue Matsuura
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Shiori Uchiyama
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Eiji Sakai
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Takuma Higurashi
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Hidenori Ohkubo
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Hiroshi Iida
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Hiroki Endo
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Koji Fujita
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Akihiko Kusakabe
2   Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
,
Kazuhiro Atsukawa
3   Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
,
Hisao Takahashi
3   Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
,
Yoko Tateishi
4   Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
,
Shin Maeda
2   Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
,
Kenichi Ohashi
4   Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
,
Atsushi Nakajima
1   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
› Author Affiliations
Further Information

Publication History

submitted 30 May 2016

accepted after revision 09 September 2016

Publication Date:
20 October 2016 (online)

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Background and study aims: The aim of this study was to investigate the capability of magnifying endoscopy with narrow-band imaging (ME-NBI) to discriminate between early carcinomas (EC) and low grade adenomas (LGA) in gastric superficial elevated epithelial neoplasias.

Patients and methods: We investigated 100 consecutive cases of gastric superficial elevated epithelial neoplasias that were removed using endoscopic submucosal dissection. The pathological diagnostic criteria were based on the revised Vienna classification; category 4 (mucosal high grade neoplasia) and category 5 (submucosal invasion by carcinoma) lesions were diagnosed as EC, whereas category 3 (mucosal low grade neoplasia) lesions were diagnosed as LGA. The associations between the postoperative pathological diagnoses and the ME-NBI findings were analyzed, and included the shape, specification, and area of irregularity in the microvascular architecture (MV) and the microsurface structure (MS).

Results: Seventy-nine EC and 21 LGA cases diagnosed postoperatively were evaluated retrospectively. The lesion size (median; range (mm)) was significantly larger in the EC group (14; 2 – 95) compared to the LGA group (5; 2 – 16) (P < 0.001). Wavy forms in the MV shapes (P = 0.031), extension in the MV specifications (P = 0.035), and area with MV irregularity (P = 0.001) were found to be statistically significant predictive findings for EC. Villous forms in the MS shapes (P = 0.026), enlargement in the MS specifications (P = 0.044), and area with MS irregularity (P = 0.021) were also found to be statistically significant predictive findings for EC. The rates of preoperative sensitivity, specificity, and diagnostic accuracy of ME-NBI for discriminating EC were 86.1 %, 38.9 %, and 75 %, respectively.

Conclusions: The present study suggests that ME-NBI is useful for the differential diagnosis of EC and LGA in gastric superficial elevated epithelial neoplasias.

Study registration: UMIN000012925.

 

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