Stomach and Intestine(Tokyo) Volume 46, Issue 6 (May 2011)

Diagnosis of the Extent of Gastric Cancer Using FICE(Flexible Spectral Imaging Color Enhancement)with Magnification Yoshimasa Miura 1 , Hiroyuki Osawa 1 , Hironori Yamamoto 1 , Hironari Ajibe 1 , Sachiko Tohma 1 , Mitsuyo Yoshizawa 1 , Jun Ushio 1 , Kiichi Satoh 1 , Kentaro Sugano 1 1Department of Intenal Medicine, Divivion of Gastroenterology, Jichi Medical University, Shimotsuke, Japan Keyword: FICE , 早期胃癌 , 範囲診断 pp.923-931
Published Date 2011/5/25
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 Early gastric cancers even with large sized diameters have been treated with endoscopic submucosal dissection. An accurate diagnosis of the extent of the tumor is very important for completing en-bloc resection successfully. The FICE system allows us to observe the entire lesion of early gastric cancer without magnification and the demarcation line between the cancerous lesion and the surrounding area with low or half magnification. The prevalence of cases with cancer-free margins in resected specimens improved from 93.8% without the FICE system to 96.7%with it. Using FICE with the new processor system(VP-4450), it improved to an extremely high level of 98.3%, but the diagnostic accuracy of cases with appropriately cancer-free margins in the resected specimens, except for cases with broader resection, showed a slightly lower level of 94.8% because of the misdiagnosis of cases with tumors more than 20mm in diameter or accompanied by a flat lesion. The extent of cancers with 0-IIb could be precisely diagnosed with an accuracy of 80%, but it is difficult to diagnose the extent of cancer in a few cases with no difference of microstructural pattern or with 0-IIb accompanied by highly well-differentiated adenocarcinoma.

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46巻6号 (2011年5月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院