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Magnifying Endoscopy with Narrow Band Imaging for Superficial Non-ampullary Duodenal Epithelial Tumors before Biopsy Shigetsugu Tsuji 1 , Hisashi Doyama 1 , Kunihiro Tsuji 1 , Kazuhiro Matsunaga 1 , Kazuyoshi Katayanagi 2 , Hiroshi Kurumaya 2 , Hiroshi Tanabe 3 , Akinori Iwashita 3 , Kenshi Yao 4 1Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan 2Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan 4Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 十二指腸上皮性腫瘍 , 生検 , NBI併用拡大内視鏡 , VS classification system , WOS pp.1554-1565
Published Date 2016/11/25
DOI https://doi.org/10.11477/mf.1403200766
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 Aim:We aimed to evaluate the diagnostic performance of M-NBI(magnifying endoscopy with narrow band imaging)in SNADETs(superficial non-ampullary duodenal epithelial tumors)before biopsy.

 Methods:We retrospectively analyzed both the M-NBI images before biopsy and the resected specimens of 27 consecutive SNADETs[light-to-medium-degree atypical tumor(LGA)group, 18 lesions;duodenal cancer and high-degree atypical tumor(EC)group, 9 lesions]. We investigated the correlation between the histopathological type of the SNADETs and the characteristic microvascular(MV)and microsurface(MS)M-NBI findings, using the established vessel plus surface(VS)classification system for the M-NBI diagnosis of early gastric cancer.

 Results:The accuracy, sensitivity, and specificity of preoperative diagnoses using M-NBI according to the VS classification system were 85.2%, 100%, and 78.9%, respectively. A WOS(white opaque substance)was present in nearly all SNADETs, obscuring the morphology of the subepithelial microvessels in 63.0% of lesions. There was no significant difference in the MV pattern between the C3 and C4 groups. The occurrence of an irregular MS pattern, especially the heterogeneous morphology of WOS, the asymmetrical distribution of WOS, and the irregular arrangement of WOS were significantly higher in the C4 group.

 Conclusions:The accuracy of M-NBI according to the VS classification system in SNADETs was useful in distinguishing carcinomas from benign lesions. However, the additional advantages of magnifying endoscopy remain unclear, and further studies are required.


Copyright © 2016, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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