Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer
Background and study aims Magnifying endoscopy with narrow band imaging (M-NBI) has made a huge contribution to endoscopic diagnosis of early gastric cancer (EGC). However, we sometimes encountered false-negative cases with M-NBI diagnosis (i. e., M-NBI diagnostic limitation lesion: M-NBI-DLL). Howe...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2020-09-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1220-6389 |
| _version_ | 1828554632039759872 |
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| author | Kohei Matsumoto Hiroya Ueyama Takashi Yao Daiki Abe Shotaro Oki Nobuyuki Suzuki Atsushi Ikeda Noboru Yatagai Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Kenshi Matsumoto Mariko Hojo Akihito Nagahara |
| author_facet | Kohei Matsumoto Hiroya Ueyama Takashi Yao Daiki Abe Shotaro Oki Nobuyuki Suzuki Atsushi Ikeda Noboru Yatagai Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Kenshi Matsumoto Mariko Hojo Akihito Nagahara |
| author_sort | Kohei Matsumoto |
| collection | DOAJ |
| description | Background and study aims Magnifying endoscopy with narrow band imaging (M-NBI) has made a huge contribution to endoscopic diagnosis of early gastric cancer (EGC). However, we sometimes encountered false-negative cases with M-NBI diagnosis (i. e., M-NBI diagnostic limitation lesion: M-NBI-DLL). However, clinicopathological features of M-NBI-DLLs have not been well elucidated. We aimed to clarify the clinicopathological features and histological reasons of M-NBI-DLLs.
Patients and methods In this single-center retrospective study, M-NBI-DLLs were extracted from 456 EGCs resected endoscopically at our hospital. We defined histological types of M-NBI-DLLs and analyzed clinicopathologically to clarify histological reasons of M-NBI-DLLs.
Results Of 456 EGCs, 48 lesions (10.5 %) of M-NBI-DLLs were enrolled. M-NBI-DLLs was classified into four histological types as follows: gastric adenocarcinoma of fundic-gland type (GA-FG, n = 25), gastric adenocarcinoma of fundic-gland mucosal type (GA-FGM, n = 1), differentiated adenocarcinoma (n = 14), and undifferentiated adenocarcinoma (n = 8). Thirty-nine lesions of M-NBI-DLLs were H. pylori-negative gastric cancers (39/47, 82.9 %). Histological reasons for M-NBI-DLLs were as follows: 1) completely covered with non-neoplastic mucosa (25/25 GA-FG, 8/8 undifferentiated adenocarcinoma); 2) well-differentiated adenocarcinoma with low-grade atypia (1/1 GA-FGM, 14/14 differentiated adenocarcinoma); 3) similarity of surface structure (10/14 differentiated adenocarcinoma); and 4) partially covered and/or mixed with a non-neoplastic mucosa (1/1 GA-FGM, 6/14 differentiated adenocarcinoma).
Conclusions Diagnostic limitations of M-NBI depend on four distinct histological characteristics. For accurate diagnosis of M-NBI-DLLs, it may be necessary to fully understand endoscopic features of these lesions using white light imaging and M-NBI based on these histological characteristics and to take a precise biopsy. |
| first_indexed | 2024-12-12T05:39:12Z |
| format | Article |
| id | doaj.art-90552811a37b4338a602cf0fc430ae08 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-12T05:39:12Z |
| publishDate | 2020-09-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-90552811a37b4338a602cf0fc430ae082022-12-22T00:35:59ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-09-010810E1233E124210.1055/a-1220-6389Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancerKohei Matsumoto0Hiroya Ueyama1Takashi Yao2Daiki Abe3Shotaro Oki4Nobuyuki Suzuki5Atsushi Ikeda6Noboru Yatagai7Yoichi Akazawa8Hiroyuki Komori9Tsutomu Takeda10Kenshi Matsumoto11Mariko Hojo12Akihito Nagahara13Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Human Pathology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanDepartment of Gastroenterology, Juntendo University, School of Medicine, Tokyo, JapanBackground and study aims Magnifying endoscopy with narrow band imaging (M-NBI) has made a huge contribution to endoscopic diagnosis of early gastric cancer (EGC). However, we sometimes encountered false-negative cases with M-NBI diagnosis (i. e., M-NBI diagnostic limitation lesion: M-NBI-DLL). However, clinicopathological features of M-NBI-DLLs have not been well elucidated. We aimed to clarify the clinicopathological features and histological reasons of M-NBI-DLLs. Patients and methods In this single-center retrospective study, M-NBI-DLLs were extracted from 456 EGCs resected endoscopically at our hospital. We defined histological types of M-NBI-DLLs and analyzed clinicopathologically to clarify histological reasons of M-NBI-DLLs. Results Of 456 EGCs, 48 lesions (10.5 %) of M-NBI-DLLs were enrolled. M-NBI-DLLs was classified into four histological types as follows: gastric adenocarcinoma of fundic-gland type (GA-FG, n = 25), gastric adenocarcinoma of fundic-gland mucosal type (GA-FGM, n = 1), differentiated adenocarcinoma (n = 14), and undifferentiated adenocarcinoma (n = 8). Thirty-nine lesions of M-NBI-DLLs were H. pylori-negative gastric cancers (39/47, 82.9 %). Histological reasons for M-NBI-DLLs were as follows: 1) completely covered with non-neoplastic mucosa (25/25 GA-FG, 8/8 undifferentiated adenocarcinoma); 2) well-differentiated adenocarcinoma with low-grade atypia (1/1 GA-FGM, 14/14 differentiated adenocarcinoma); 3) similarity of surface structure (10/14 differentiated adenocarcinoma); and 4) partially covered and/or mixed with a non-neoplastic mucosa (1/1 GA-FGM, 6/14 differentiated adenocarcinoma). Conclusions Diagnostic limitations of M-NBI depend on four distinct histological characteristics. For accurate diagnosis of M-NBI-DLLs, it may be necessary to fully understand endoscopic features of these lesions using white light imaging and M-NBI based on these histological characteristics and to take a precise biopsy.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1220-6389 |
| spellingShingle | Kohei Matsumoto Hiroya Ueyama Takashi Yao Daiki Abe Shotaro Oki Nobuyuki Suzuki Atsushi Ikeda Noboru Yatagai Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Kenshi Matsumoto Mariko Hojo Akihito Nagahara Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer Endoscopy International Open |
| title | Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer |
| title_full | Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer |
| title_fullStr | Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer |
| title_full_unstemmed | Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer |
| title_short | Diagnostic limitations of magnifying endoscopy with narrow-band imaging in early gastric cancer |
| title_sort | diagnostic limitations of magnifying endoscopy with narrow band imaging in early gastric cancer |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1220-6389 |
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