Can magnifying endoscopy with narrow-band imaging discriminate between carcinomas and low grade adenomas in gastric superficial elevated lesions?
Endosc Int Open
; 4(11): E1203-E1210, 2016 Nov.
Article
em En
| MEDLINE
| ID: mdl-27853747
ABSTRACT
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 andmethods:
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; 2â-â95) compared to the LGA group (5; 2â-â16) (Pâ<â0.001). Wavy forms in the MV shapes (Pâ=â0.031), extension in the MV specifications (Pâ=â0.035), and area with MV irregularity (Pâ=â0.001) were found to be statistically significant predictive findings for EC. Villous forms in the MS shapes (Pâ=â0.026), enlargement in the MS specifications (Pâ=â0.044), and area with MS irregularity (Pâ=â0.021) 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 86.1â%, 38.9â%, and 75â%, 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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MEDLINE
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En
Ano de publicação:
2016
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Article