Application of magnifying narrow-band imaging endoscopy for diagnosis of early gastric cancer and precancerous lesion

Abstract

BackgroundGastric carcinoma is the second commonest cause of cancer deaths worldwide. Early detection and diagnosis of gastric cancer in the stomach is important for improving the prognosis of gastric cancer. This retrospective study was designed to investigate the value of magnifying narrow-band imaging (NBI) in the diagnosis of precancerous lesions and early gastric cancer.MethodsThis study included 122 patients who were diagnosed with early gastric cancer or precancerous gastric lesions by endoscopy. The patients underwent an examination with conventional endoscopy, magnifying NBI, and magnifying chromoendoscopy. Images resolution was evaluated, and the morphology, pit patterns and blood capillary forms of lesions were analyzed. The presence of gastric carcinoma and high grade intraepithelial neoplasia in the biopsy samples was considered as a positive pathological result, which is used to assess accuracy of endoscopic diagnosis.ResultsFor image resolution, magnifying NBI and magnifying chromoendoscopy were significantly superior to magnifying conventional endoscopy in morphology, pit pattern and blood capillary form (P < 0.01), and magnifying NBI was significantly superior to magnifying chromoendoscopy in blood capillary form (P < 0.01). IV, V1, and VI type of gastric pit pattern were detected in 14 cases, 43 cases, and 17 cases in patients with high grade intraepithelial neoplasia, respectively. V1 and VI type of gastric pit pattern were detected in 9 cases and 39 cases in patients with early gastric cancer, respectively. The presence of irregular minute vessels and variation in the caliber of vessels was found in 109 cases. The accuracy, sensitivity, specificity, false positive rate and false negative rate for diagnosis of early gastric cancer and precancerous gastric lesions were 68.9%, 95.1%, 63.1%, 24.5%, and 32.4% for conventional endoscopy, 93.6%, 92.7%, 94.5%, 5.7%, and 6.9% for magnifying NBI, and 91.3%, 88.6%, 93.2%, 13.2%, and 21.48% for magnifying chromoendoscopy, respectively.ConclusionsThis study demonstrates that magnifying NBI is superior to conventional endoscopy in the diagnosis of early gastric cancer and precancerous gastric lesions, and can be used for screening early malignancies of the stomach.

Meta‐analysis: The diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions

“…Additionally, Correa's model of human gastric carcinogenesis has been accepted, which represents apparent sequential steps as follows: chronic superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, dysplasia, and gastric cancer. It is known to all that if gastric cancer can be detected in early stage, the prognosis for it is excellent, the survival rate is greater than 90% in 5 years, and curative endoscopic resection may be possible in some cases of EGC and precancerous gastric lesions . Thus, in this study, PGLs include chronic atrophic gastritis, intestinal metaplasia, neoplasia, and hyperplasia.…”

Diagnóstico precoz de cáncer gástrico: Propuesta de detección y seguimiento de lesiones premalignas gástricas: protocolo ACHED

“…Durante el procedimiento se puede utilizar NAC o ácido acético a 1,5% adicional, pero esto no reemplaza su uso previo 79 Es importante una distensión gástrica completa, para explorar toda la superficie gástrica. La utilización de índigo carmín o azul de metileno, la magnificación óptica y el uso de narrow band imaging (NBI) y probablemente otros sistemas de cromoscopia electrónica (FICE o I-Scan) permiten caracterizar mejor las lesiones 80,81 . En Japón, el registro sistemático de imágenes es parte integral de toda EDA.…”

Is Image-Enhanced Endoscopy Useful for the Diagnosis and Treatment of Gastrointestinal Tumor?

“…It is not certain whether the use of NBI-only in observing the mucosal lesion has more advantage than the use of chromoscopy, but a combined use of NBI with magnifying endoscopy has a definite advantage in observing the microstructure and the microvasculature of the mucosal surface. Practically most studies that reported favorable results in the diagnoses of lesions used both NBI and magnifying endoscopy rather than white light endoscopy or chromoscopy 1-4…”