Japanese

Usefulness and Limitations of the Magnifying Endoscopic Diagnosis for Colorectal Lesions Ken Yamashita 1 , Shiro Oka 2 , Fumiaki Tanino 2 , Noriko Yamamoto 2 , Yuki Kamigaichi 2 , Hirosato Tamari 2 , Katsuaki Inagaki 2 , Yuki Okamoto 2 , Hidenori Tanaka 2 , Kyoku Sumimoto 1 , Shinji Tanaka 1 1Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan 2Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan Keyword: 大腸腫瘍 , NBI , JNET分類 , pit pattern分類 pp.1013-1021
Published Date 2021/7/25
DOI https://doi.org/10.11477/mf.1403202501
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 JNET(the Japan NBI Expert Team)classification consists of four categories(Types 1, 2A, 2B, and 3). Types 1, 2A, and 3 are reliable indicators, with high diagnostic accuracy for hyperplastic polyp/sessile serrated polyp, low-grade intramucosal dysplasia, and deep submucosal invasive carcinoma, respectively. There is no need to enhance a diagnostic pattern for these lesions using dyes. Otherwise, the diagnostic ability of Type 2B for high-grade intramucosal dysplasia/superficial submucosal invasive carcinoma is insufficient. A pit pattern diagnosis should be made to define a more precise Type 2B lesion or in low-confidence categories. Type 2B and IIIS/IIIL/IV/VI mild pit pattern lesions are a good indication for endoscopic resection. However, about half of the Type 2B and IIIS/IIIL/IV/VI severe pit pattern lesions are deep submucosal invasive carcinomas. Therefore, additional assessments, such as endoscopic ultrasound or barium enema X-ray examination, are necessary for an accurate diagnosis of Type 2B and IIIS/IIIL/IV/VI severe pit pattern lesions. We divided JNET Type 2B into Type 2B-low and Type 2B-high lesions. JNET Type 2B-low lesion is a good indication for endoscopic resection ; therefore, an additional pit pattern diagnosis may not be necessary. Whereas, JNET Type 2B-high lesion includes several histopathologies ; thus, an additional pit pattern diagnosis is necessary.


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