Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

Abstract

AIM:To investigate the relationship between postendoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME. From January, 2007 to June, 2008 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies. METHODS: RESULTS:CE findings showed nodular scars (53/129), erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (Ⅰ) 47 round; (Ⅱ) 54 short rod or tubular; (Ⅲ) 19 branched or gyrus-like; and (Ⅳ) 9 destroyed pits. Sensitivity and specificity were 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type Ⅳ pit patterns were diagnosed as tumor lesions, and 120 cases of type Ⅰ-Ⅲ pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%. CONCLUSION: ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.

Application of Current Image-Enhanced Endoscopy in Gastric Diseases

“…They argued that ME-NBI is the most effective method for predicting local recurrences during follow-up endoscopy. 34…”

Current Clinical Applications of Magnifying Endoscopy with Narrow Band Imaging in the Stomach

“…However, less has been reported regarding the correlation of endoscopic findings and pathological findings in post-ER scars, as well as a detailed description of ME-NBI findings in the altered mucosa ( Figure 5 ). In 2009, a prospective short-term follow-up study investigated the relationship between magnifying findings of post-ER scars and the pathological diagnosis [ 43 ]. They found that the presence of nodularity on conventional endoscopy suggested tumor lesions with a sensitivity of 88.9% and a specificity of 62.5%.…”