Usefulness of Magnifying Endoscopy with Narrow-Band Imaging for Determining Tumor Invasion Depth in Early Gastric Cancer

Abstract

Backgrounds. Magnifying endoscopy with narrow-band imaging (ME-NBI) has become essential for determining tumor margin in early gastric cancer (EGC). Here, we investigated the usefulness of ME-NBI for assessment of invasion depth in EGC. Methods. For 119 patients who had undergone ME-NBI and en bloc resection by endoscopic submucosal dissection, three physicians prospectively examined high-magnification ME-NBI images for clinical features such as presence or absence of dilated vessels (D vessels). Cases with D vessels verified by at least two physicians were assigned to group V, and others were assigned to group N. We then compared clinicopathological factors associated with the groups. Results. Groups V and N consisted of 18 and 101 patients, respectively. There were no significant differences in age, gender, tumor size, tumor location, gross morphology, or histological type. The percentage of submucosal cancer was 9.9% (10/101) in group N and significantly higher at 33.3% (6/18) in group V (P = 0.007). When the presence of D vessels was considered a diagnostic criterion for submucosal cancer, diagnostic accuracy, sensitivity, and specificity were 81.5, 37.5, and 88.3%, respectively. Conclusions. The results suggest that identification of D vessels using ME-NBI can assist in the assessment of invasion depth in EGC.

Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA‐G)

“…Studies were excluded if they were not original reports on the diagnosis of EGC or if they were case reports. After this filtering, 66 articles were selected for use in this algorithm (57 from PubMed and nine from the manual search) …”

Diagnostic performance of conventional endoscopy in the identification of submucosal invasion by early gastric cancer: the “non-extension sign” as a simple diagnostic marker

“…Furthermore, its diagnostic ability is similar to that of CE alone [15][16][17], and a number of studies have stated that EUS is unsuitable as a routine investigation for determining the depth of invasion by EGCs [15]. In recent years, there have been some promising reports regarding the determination of invasion depth using new modalities such as infrared endoscopy [18] and magnifying endoscopy with narrow-band imaging [19], but these are yet to produce consistently reliable results.…”

Evidence based review of the impact of image enhanced endoscopy in the diagnosis of gastric disorders

“…In the first study by Kobara et al[63] it was concluded that the presence of non-structure, scattery vessels and multi-caliber vessels can possibly serve as indicators of SM2 invasion in differentiated-type of EGC. In the second study by Kikuchi et al[64] M-NBI images were examined for dilated vessels (D-vessels) which were defined as vessels with diameter 3 times larger than that of the irregular microvessels. The sensitivity and specificity of D-vessels for SM2 invasion were 37.5% and 88.3% respectively.…”