Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

被引：37

作者：

Tsuji, Yosuke ^{[1
,2
]}

Ohata, Ken ^{[1
]}

Sekiguchi, Masau ^{[1
]}

Ohno, Akiko ^{[1
]}

Ito, Takafumi ^{[1
]}

Chiba, Hideyuki ^{[1
]}

Gunji, Toshiaki ^{[3
]}

Fukushima, Jun-ichi ^{[4
]}

Yamamichi, Nobutake ^{[2
]}

Fujishiro, Mitsuhiro ^{[5
]}

Matsuhashi, Nobuyuki ^{[1
]}

Koike, Kazuhiko ^{[2
]}

机构：

[1] NTT Med Ctr Tokyo, Dept Gastroenterol, Shinagawa Ku, Tokyo 1418625, Japan

[2] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Bunkyo Ku, Tokyo 1138655, Japan

[3] NTT Med Ctr Tokyo, Dept Prevent Med, Shinagawa Ku, Tokyo 1418625, Japan

[4] NTT Med Ctr Tokyo, Dept Pathol, Shinagawa Ku, Tokyo 1418625, Japan

[5] Univ Tokyo, Grad Sch Med, Dept Endoscopy & Endoscop Surg, Bunkyo Ku, Tokyo 1138655, Japan

来源：

GASTRIC CANCER | 2012年 / 15卷 / 04期

关键词：

Magnifying endoscopy; Narrow-band imaging; Gastric adenoma; DIFFERENTIAL-DIAGNOSIS; FORCEPS BIOPSY; RISK-FACTORS; LESIONS;

D O I：

10.1007/s10120-011-0133-2

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

There are no clear clinical criteria for the management of gastric lesions diagnosed as adenomas (Vienna classification category 3) by pre-treatment biopsy. In the present study, we examined the feasibility of magnifying endoscopy with narrow-band imaging (ME-NBI) in discriminating early gastric cancers (Vienna classification category 4 or 5) from adenomas in lesions diagnosed as adenomas by pre-treatment biopsy. This was a single-center cross-sectional retrospective study at a tertiary referral center. One hundred thirty-seven consecutive cases of gastric lesions diagnosed as adenomas in pre-treatment forceps biopsy were examined with conventional non-magnifying endoscopy under white light, non-magnifying chromoendoscopy, and ME-NBI. We investigated the association between the final pathological diagnoses (carcinoma or adenoma) and the following factors: lesion size (mm), color (red or white), macroscopic type (depressed or others), presence of ulceration, and positive ME-NBI finding. The presence of an irregular microvascular pattern or an irregular microsurface pattern with a demarcation line between the lesion and the surrounding area was regarded as a positive ME-NBI finding. Lesion size was significantly larger in carcinomas than adenomas (P = 0.005). Depressed lesion (P = 0.011), red color (P < 0.001), and positive ME-NBI finding (P < 0.001) were significant predictive factors for carcinoma. Multivariate logistic regression confirmed that red color (odds ratio [OR] 3.04, 95% confidence interval [CI] 1.26-7.34, P = 0.14) and a positive ME-NBI finding (OR 13.68, 95% CI 5.69-32.88, P < 0.001) were independent predictive factors for carcinomas. A positive ME-NBI finding was the strongest predictive factor. ME-NBI is useful in planning the management of lesions diagnosed as adenomas by pre-treatment forceps biopsy.

引用

页码：414 / 418

页数：5

共 23 条

[21] Elevated risk for gastric adenocarcinoma can be predicted from histomorphology [J].