<i>In vivo</i> diagnosis of early‐stage gastric cancer found after <i>Helicobacter pylori</i> eradication using probe‐based confocal laser endomicroscopy

Horiguchi, Noriyuki; Tahara, Tomomitsu; Yamada, Toshimoto; Yoshida, Dai; Okubo, Masaaki; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Shibata, Tomoyuki; Tsukamoto, Tetsuya; Kuroda, Makoto; Ohmiya, Naoki

doi:10.1111/den.12926

Cited by 22 publications

(17 citation statements)

References 20 publications

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“…The present study showed that dark pleomorphic nests and disorganized irregular‐shaped dark glands were observed in patients with rectal metastasis from lung adenocarcinoma and SEL‐like extremely well‐differentiated gastric adenocarcinoma, respectively. We also reported that probe‐based CLE showed irregular dark nests in jejunal metastasis from cervical cancer, disorganized irregular dark glands in early‐stage gastric cancer covered by nontumorous regenerative epithelium or maturated atypical glands found after Helicobacter pylori eradication, and back‐to‐back orientation of dark crypts in ulcerative colitis‐associated differentiated adenocarcinoma and dark trabecular architecture in ulcerative colitis‐associated undifferentiated adenocarcinoma . The Miami classification system based on a consensus of probe‐based CLE users to standardize categorization of images indicated that all cancers in the esophagus, stomach, colorectum, and biliary duct were characterized by disorganized structures of dark (“nonrefractile”) epithelium or cells .…”

Section: Discussionmentioning

confidence: 85%

Endoscopic ultrasound‐guided needle‐based confocal laser endomicroscopy in gastrointestinal subepithelial lesions: Feasibility study

Terada

Tahara

Hashimoto

et al. 2019

Digestive Endoscopy

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Background and Aim: Needle-based confocal laser endomicroscopy (nCLE) allows for real-time optical biopsies during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Little is known about nCLE imaging of gastrointestinal subepithelial lesions (GI-SEL); therefore, we determined its feasibility.Methods: We carried out EUS, nCLE, and finally FNA in 25 patients with GI-SEL between November 2015 and December 2018. We retrospectively compared nCLE findings with pathological findings of EUS-FNA or surgical specimens. For concordance analysis, two endoscopists independently validated representative nCLE images 5 months or more after examinations.Results: Adequate sample acquisition rate of EUS-FNA was 67% per needle pass and 96% per patient. EUS-FNA was diagnostic in 80% (20/25), suspicious in 4% (1/25), and nondiagnostic in 16% (4/ 25). nCLE image acquisition rate was 100% and its concordance rate with final pathology was 88% (22/25), which was not significantly different from diagnostic and suspicious EUS-FNA. nCLE could differentiate GI stromal tumors (GISTs) from leiomyoma, in that GISTs were characterized by contrast-enhanced densely populated spindle cell tumors with unenhanced rodshaped nuclei in 93% of 14 patients, whereas leiomyomas were characterized by narrower spindle cell tumors with fewer and smaller unenhanced nuclei in 100% of three patients. In rectal metastasis from lung adenocarcinoma, some pleomorphic dark nests were observed. At concordance analysis between the two endoscopists' validation results, j value was 0.560 (P < 0.001), indicating moderate agreement. There were no adverse events associated with nCLE and EUS-FNA.Conclusion: Needle-based confocal laser endomicroscopy can be safe and useful for on-site detection of abnormalities of GI-SEL (UMIN 000013857).

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Section: Discussionmentioning

confidence: 85%

Endoscopic ultrasound‐guided needle‐based confocal laser endomicroscopy in gastrointestinal subepithelial lesions: Feasibility study

Terada

Tahara

Hashimoto

et al. 2019

Digestive Endoscopy

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“… 2 Even if regenerating nontumorous epithelium overlies the tumorous tissue, pCLE may be able to detect it by visualization of the subsurface microscopic architecture less than 100 μm in depth. 3 In conclusion, pCLE could help in the in vivo diagnosis of submucosal hypervascular tumors such as GIST in cases in which biopsy is not recommended.…”

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confidence: 97%

Jejunal GI tumor using probe-based confocal laser endomicroscopy

et al. 2018

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“…For the first cohort of 20 SNADET lesions (16 adenomas and 4 carcinomas), pCLE scanning of the targeted lesions and the adjacent normal mucosa was retrospectively evaluated and suggestive abnormal pCLE findings were examined in relation to their histological findings. To define suggestive pCLE findings to distinguish non-neoplastic and neoplastic tissue in SNADET lesions, we consulted several reports about pCLE findings of neoplastic tissues in the gastrointestinal tract 4 6 7 8 15 16 17 . Features capable of distinguishing gastrointestinal non-neoplastic and neoplastic tissue by pCLE imaging have been summarized in the Miami Classification system 4 .…”

Section: Methodsmentioning

confidence: 99%

Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors

et al. 2019

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Background and study aims Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings. Patients and methods pCLE scanning of 20 SNADET lesions including 16 adenomas and four carcinomas was retrospectively evaluated to explore abnormal pCLE findings in relation to histological features. Diagnostic yield of pCLE findings was prospectively evaluated in an additional 20 SNADET lesions including 16 adenomas and four carcinomas. Results In a retrospective study, we identified four abnormal pCLE findings of SNADETs: (1) dark epithelium, (2) columnar cells irregularly extending to the lumen, (3) distorted crypt structure, and (4) fluorescein leakage. Dark epithelium distinguished neoplastic lesions (adenomas and carcinomas) from non-neoplastic duodenal mucosa with a sensitivity of 90 % and a specificity of 100 %. Distorted crypt structure distinguished carcinomas from adenomas and non-neoplastic duodenal mucosa with a sensitivity of 100% and a specificity of 94 %. In the prospective study, the sensitivity and the specificity of the dark epithelium for the diagnosis of neoplastic lesions (adenomas + carcinomas) was 75% and 100 %. Sensitivity and the specificity of the distorted crypt structure for discrimination of carcinoma from adenoma were 100 % and 94 %, respectively. Conclusions The pCLE findings correlated with the histopathology of the SNADETs. Dark epithelium and distorted crypt structure were informative pCLE findings to predict presence of neoplasia and cancer in the SNADET, respectively. UMIN-CTR UMIN000013857 TRIAL REGISTRATION: Single-Center, prospective observational trial UMIN000013857 at

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In vivo diagnosis of early‐stage gastric cancer found after Helicobacter pylori eradication using probe‐based confocal laser endomicroscopy

Abstract: pCLE may be helpful for the diagnosis of ambiguous ECG found after Hp eradication because it enables real-time scanning throughout the lesion and detection of subsurface microstructure.

Cited by 22 publications

References 20 publications

Endoscopic ultrasound‐guided needle‐based confocal laser endomicroscopy in gastrointestinal subepithelial lesions: Feasibility study

Endoscopic ultrasound‐guided needle‐based confocal laser endomicroscopy in gastrointestinal subepithelial lesions: Feasibility study

Jejunal GI tumor using probe-based confocal laser endomicroscopy

Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors

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