Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan.
Dig Endosc. 2014 Jan;26(1):57-62. doi: 10.1111/den.12076. Epub 2013 Apr 7.
Magnifying endoscopy with narrow-band imaging (ME-NBI) can visualize crypt openings (CO) as slit-like structures in gastric epithelial neoplasia. Visualization of numerous CO is characteristic of low-grade adenoma (LGA). The aim of the present study was to investigate whether visualization of CO by ME-NBI is useful for discriminating between LGA and early gastric cancer (EGC).
Fifty-one superficial elevated-type gastric neoplasias (10 LGA and 41 EGC) were retrospectively evaluated. The presence of CO and the number of CO were evaluated in endoscopic photos obtained at high-power endoscopic magnification by ME-NBI. The optimal cut-off value for the number of CO visualized to discriminate between LGA and EGC was determined by receiver operating characteristic curve analysis.
The mean number of CO visualized was significantly larger in the LGA group than in the EGC group (31.2, 95% confidence interval [CI] 16.3-46.1 vs 6.3, 95% CI 3.6-9.0; P < 0.001). When the cut-off for the number of CO visualized was set at 20, the sensitivity, specificity, and accuracy of dense-type CO for discriminating between LGA and EGC were 90.0%, 87.8%, and 88.2%, respectively.
Determining the number of CO visualized in superficial elevated-type gastric neoplasias by ME-NBI appears to be a useful method for discriminating between LGA and EGC.
窄带成像放大内镜（ME-NBI）可以将胃上皮肿瘤中的隐窝开口（CO）可视化成像为缝隙样结构。大量 CO 的可视化是低级别腺瘤（LGA）的特征。本研究旨在探讨 ME-NBI 下 CO 的可视化是否有助于区分 LGA 和早期胃癌（EGC）。
回顾性评估了 51 例浅表隆起型胃肿瘤（10 例 LGA 和 41 例 EGC）。通过 ME-NBI 高倍内镜放大观察内镜照片评估 CO 的存在和 CO 的数量。通过受试者工作特征曲线分析确定区分 LGA 和 EGC 的最佳 CO 可视化数量的截断值。
LGA 组 CO 的平均数量明显大于 EGC 组（31.2，95%置信区间[CI] 16.3-46.1 与 6.3，95%CI 3.6-9.0；P < 0.001）。当 CO 可视化数量的截断值设定为 20 时，密集型 CO 区分 LGA 和 EGC 的敏感性、特异性和准确性分别为 90.0%、87.8%和 88.2%。
通过 ME-NBI 确定浅表隆起型胃肿瘤中 CO 的数量似乎是区分 LGA 和 EGC 的一种有用方法。
