Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer

Horii, Yusuke; Dohi, Osamu; Naito, Yuji; Takayama, Shin; Ogita, Kazuyuki; Terasaki, Kei; Nakano, Takahiro; Majima, Atsushi; Yoshida, Naohisa; Kamada, Kazuhiro; Uchiyama, Kazuhiko; Ishikawa, Takeshi; Takagi, Tomohisa; Handa, Osamu; Konishi, Hideyuki; Yagi, Nobuaki; Yanagisawa, Akio; Itoh, Yoshito

doi:10.1159/000494053

Cited by 14 publications

(9 citation statements)

References 17 publications

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“…In this study, the negative resection rate of horizontal margin after ESD and surgery was 97.4% (95% CI: 92.1%-1.0%) though there were almost no difference between that of UD-type EGC and D-type EGC. The negative resection rate of HM was found to be higher than the delineation accuracy of EGC margins, which may be due to the second biopsy after the first positive biopsy [ 17 ], and the extended resection is usually 5 mm outside the margin [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, ME-NBI was also deemed useful in delineating the horizontal margin of EGC [ 6 , 7 ], although its diagnostic accuracy was variable from 69% to 100% [ 9 – 18 ]. The capacity for demarcating the margins of EGC correctly by ME-NBI might be influenced by Helicobacter pylori ( H. pylori ) statues [ 12 , 16 ], tumor-occupied site [ 17 ], and tumor size [ 17 ], among other factors. Therefore, the primary purpose of this meta-analysis was to evaluate the diagnostic accuracy of ME-NBI for the demarcation of EGC margins.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis

Chen

Maher

et al. 2021

Gastroenterology Research and Practice

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Background. Accurate delineation of tumor margin is essential for complete resection of early gastric cancer (EGC). The objective of this study is to assess the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) for the accurate demarcation of EGC margins. Methods. We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases up to March 2020 to identify eligible studies. The diagnostic accuracy of ME-NBI for EGC margins was calculated, and subgroup analyses were performed based on tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, Helicobacter pylori (H. pylori), and endoscopists’ experience. Besides, we also evaluated the negative and positive resection rates of the horizontal margin (HM) of EGC after endoscopic submucosal dissection (ESD) and surgery. Results. Ten studies comprising 1018 lesions were eligible in the databases. The diagnostic accuracy of ME-NBI for the demarcation of EGC margins was 92.4% (95% confidence interval (CI): 86.7%-96.8%). According to ME-NBI subgroup analyses, the rate of accurate evaluation of EGC margins was not associated with H. pylori infection status, tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, and endoscopists’ experience, and no statistical differences were found in subgroup analyses. Moreover, the negative and positive resection rates of HM after ESD and surgery were 97.4% (95% CI: 92.1%-100%) and 2.6% (95% CI: 0.02%-7.9%), respectively. Conclusions. ME-NBI enables a reliable delineation of the extent of EGC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis

Chen

Maher

et al. 2021

Gastroenterology Research and Practice

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“…In contrast, in the M-BLI-BC group, a clear DL was preoperatively diagnosed using M-BLI and biopsies taken in 4 directions from background noncancerous tissue ≈ 5 mm outside the EGC lesion for histopathological confirmation according to our previous study (Fig. 1d–i; Video 1) [7]. When biopsy specimens were diagnosed as adenocarcinoma, the DL was rediagnosed at a later date and ESD was performed after the biopsy specimen was diagnosed as noncancerous tissue.…”

Section: Methodsmentioning

confidence: 99%

“…We conventionally perform biopsy confirmation in 4 directions from background mucosa surrounding the lesion to prevent as much error as possible in the determination of the DL in addition to M-NBI because there was not enough evidence of M-NBI diagnosis. In our previous retrospective study, the diagnostic accuracy of M-NBI in identifying the DL of EGCs was 98.1% in well-differentiated EGCs and the rate of negative horizontal margins in ESD specimens was achieved to be 99.2% by biopsy confirmation [7]. Therefore, biopsy confirmation was not needed for all the well-differentiated EGCs after diagnosis of the DL using M-NBI.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Feasibility of Magnifying Blue Laser Imaging without Biopsy Confirmation for the Diagnosis of the Demarcation of Gastric Tumors: A Randomized Controlled Study

Nakano

Dohi

Naito

et al. 2020

Dig Dis

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Background: Accurate diagnosis of the demarcation line (DL) of gastric tumors is essential for curative complete resection by endoscopic submucosal dissection (ESD). It is controversial to perform only magnifying endoscopy for diagnosing the DL of gastric tumors prior to ESD. This study aimed to evaluate the diagnostic accuracy for the DL of gastric adenomas and well-differentiated adenocarcinomas using only magnifying blue laser imaging (M-BLI) compared with that using both M-BLI and biopsy confirmation. Methods: In this prospective, single-center study, 96 well-differentiated adenocarcinomas and 32 gastric adenomas were enrolled between July 2015 and December 2016. A total of 122 lesions with a clear DL on M-BLI were randomly allocated to undergo M-BLI only (the M-BLI group) or M-BLI with biopsy confirmation (the M-BLI-BC group), performed as biopsies in 4 directions from noncancerous tissues ≈ 5 mm outside the lesion before ESD. The primary end point was to clarify the noninferiority of M-BLI without biopsy confirmation compared with that with biopsy confirmation, in terms of the diagnostic accuracy and complete resection. Results: There were no significant differences in sex, median age, color, circumference, macroscopic type, biopsy-based diagnosis, and Helicobacter pylori infection between the 2 groups. The diagnostic accuracy for the DL was 100 and 95.0% and the complete resection was 100 and 100% in the M-BLI and M-BLI-BC groups, respectively. Conclusion: The diagnostic ability of M-BLI is excellent in diagnosing the demarcation of gastric adenoma and well-differentiated adenocarcinoma. Biopsy confirmation is not needed for these lesions with a clear DL by M-BLI.

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“…Similarly, several studies have demonstrated that M-NBI endoscopy improves the determination of horizontal extent before ESD in patients with an unclear margin of EGC[ 63 , 64 ]. Horii et al[ 65 ] showed that diagnostic accuracy using M-NBI was 96.7% when the successful demarcation of EGC was evaluated on the basis of the biopsy-negative rate outside the tumor. Complete resection of EGC with a tumor-negative horizontal margin was achieved in 97.9% ( n = 323/330).…”

Section: Early Gastric Cancermentioning

confidence: 99%

Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia

Cho¹,

Jeon²,

Jin³

2020

WJCC

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Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori ( H . pylori ) infection. The regular arrangement of collecting venules (RAC) is seen in the normal gastric corpus, whereas mucosal swelling and redness without RAC are observed in H . pylori -infected mucosa. Despite successful H . pylori eradication, the presence of atrophic gastritis and/or gastric intestinal metaplasia (GIM) is a risk factor for gastric cancer. With the development of advanced imaging technologies, recent studies have reported the usefulness of narrow-band imaging (NBI) for endoscopic diagnosis of atrophic gastritis and GIM. Using NBI endoscopy with magnification (M-NBI), atrophic gastritis is presented as irregular coiled microvessels and loss of gastric pits. Typical M-NBI endoscopic findings of GIM are a light blue crest and a white opaque substance. Based on the microvascular patterns, fine network, core vascular, and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions. For diagnosis of early gastric cancer (EGC), a systematic classification using M-NBI endoscopy has been proposed on the basis of the presence of a demarcation line and an irregular microvascular/microsurface pattern. Furthermore, M-NBI endoscopy has been found to be more accurate for determining the horizontal margin of EGC compared to conventional endoscopy. In this review, we present up-to-date results on the clinical usefulness of gastroscopy with NBI for the diagnosis of H . pylori gastritis, precancerous gastric lesion, and neoplasia.

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Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer

Cited by 14 publications

References 17 publications

Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis

Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis

Efficacy and Feasibility of Magnifying Blue Laser Imaging without Biopsy Confirmation for the Diagnosis of the Demarcation of Gastric Tumors: A Randomized Controlled Study

Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia

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