Japanese

New Developments in The Histological Classification of Adenomas and Differentiated Carcinomas:Endoscopic Diagnosis of Adenomas and Differentiated Carcinoma Takao Kanemitsu 1 , Kenshi Yao 1 , Kentaro Imamura 2 , Satoshi Nimura 3 , Masaki Miyaoka 1 , Kensei Ohtsu 2 , Yoichiro Ono 2 , Toshiharu Ueki 2 , Takahiro Ono 2,3 , Atsuko Ota 4 , Hiroshi Tanabe 3 , Seiji Haraoka 3 , Akinori Iwashita 5 , Takashi Nagahama 6 1Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan 4Department of Clinical Laboratory, Fukuoka University Chikushi Hospital, Chikushino, Japan 5AII Pathological Image Institute, Ogoori, Japan 6Nagahama GIE Clinic, Fukuoka, Japan Keyword: C-WLI , M-NBI , 表面隆起型上皮性腫瘍 , 腺腫 , 分化型癌 pp.1261-1273
Published Date 2021/9/25
DOI https://doi.org/10.11477/mf.1403202551
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 Although magnifying endoscopic diagnosis is performed according to the magnifying endoscopy simple diagnostic algorithm for early gastric cancer in routine medical care at our department, the diagnostic efficacy of magnifying endoscopy in actual clinical practice has not yet been evaluated. Thus, the efficacy of actual C-WLI(conventional endoscopy with white light imaging)and M-NBI(magnifying endoscopy with narrow band imaging)for the diagnosis of superficial elevated epithelial tumors was evaluated at our department.

 The efficacy of C-WLI and M-NBI for diagnosing patients with superficial elevated epithelial tumors(low-grade adenoma ; 19 lesions ; high-grade cancer, low-grade cancer, and borderline malignant lesions, 92 lesions)who underwent endoscopic submucosal dissection was evaluated at our department.

 The sensitivity, specificity, and accuracy of C-WLI for the diagnosis of superficial elevated epithelial tumors were 45.7%(41.4-48.6%), 73.7%(53.3-87.8%), and 50.5%(43.5-55.3%), respectively, and the sensitivity, specificity, and accuracy for M-NBI for the diagnosis of the same were 87.0%(83.0-90.2%), 63.2%(44.0-78.8%), and 82.9%(76.3-88.2%), respectively. M-NBI had statistically significantly higher sensitivity and accuracy than C-WLI. Five of the six false-negative lesions in the M-NBI high-confidence arm had weak superficial atypia and were difficult to diagnose as cancer using M-NBI. The remaining lesion was misread by the performing physician. Moreover, the only false-positive patient was diagnosed with cancer because of the effect of a biopsy.

 The diagnostic performance of M-NBI was superior to that of C-WLI in terms of sensitivity and accuracy. Histopathologically, lesions with weak structural atypia on the tumor surface were the diagnostic limit for M-NBI.


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

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