Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer.

AIM

To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis.

METHODS

We studied 112 ECC lesions [mucosal/submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] > or = 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnification colonoscopy pit pattern diagnosis.

RESULTS

Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense [odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis.

CONCLUSION

Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.