Endoscopic Detection of Early Esophageal Cancer by the Narrow Band Imaging System Kumiko Momma 1 , Misao Yoshida 2 , Junko Fujiwara 1 , Takeo Arakawa 1 , Takashi Fujiwara 3 , Hideto Egashira 3 , Naoto Egawa 3 , Akinori Miura 4 , Tsuyoshi Kato 4 , Yousuke Izumi 4 , Tetsuo Nemoto 5 , Nobuaki Funada 5 1Department of Endoscopy, Tokyo Metropolitan Komagome Hospital 2Department of Surgery, Tokyo Metropolitan Bokutoh Hospital 3Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital 4Department of Surgery, Tokyo Metropolitan Komagome Hospital 5Department of Pathology, Tokyo Metropolitan Komagome Hospital Keyword: 狭帯域内視鏡システム(narrow band imaging ; NBI) , 食道早期癌 , 拾い上げ診断 , ヨード染色 pp.151-164
Published Date 2006/2/25
DOI https://doi.org/10.11477/mf.1403100268
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The narrow band imaging system(NBI)is a new illumination method that make it possible to visualize superficial vessels of the gastrointestinal tract. Thin blood vessels such as capillaries of the mucosa can be seen as a brown pattern. Thirty eight demarcated brownish areas were detected among 1,322 patients by upper endoscopy aided by the NBI system. The demarcated brownish areas on the NBI system were classified into 3 types. Type1 : All of the 32 lesions in which intra-papillary capillary loops(IPCL)were increasing showed carcinoma. Type 2 : 2 lesions in which IPCL were unable to be seen, and which had irregular surfaces showed atypical epithelium. Type 3 : 4 lesions whose surfaces were exfoliated slightly and depressed showed normal epithelium. Thirty cases(93.8 %)of 32 superficial esophageal carcinomas were detected by conventional endoscopy, but the other 2 cases(6.3 %)were not detected. The NBI system was able to detect them. The 2 lesions were a very small lesion with slight reddening and a flat lesion at the anterior wall of the lower esophagus. On NBI observation, all of the 32 cancer cases were recognized easier than by conventional observation. The range of iodine unstained areas and NBI observation were corresponded in a total of 31 cases including carcinoma in situ occupying the whole epithelium and a tumor invading to the lamina propria mucosae or more. However endoscopic delineation of a mucosal cancer aided by NBI failed in one case in which cancer cells were limited to the basal layer of the epithelium. NBI is a powerful tool for identifying squamous cell carcinomas confined to the mucosa, because it was able to detect all of the cases regardless of their location or size.

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