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使用窄带成像放大内镜改善侧向扩散型“0-IIb”胃病变的光学识别。

Improved optical identification of laterally spreading type "0-IIb" gastric lesion with narrow band imaging magnification endoscopy.

作者信息

Eleftheriadis Nikolas, Inoue Haruhiro, Ikeda Haruo, Maselli Roberta, Onimaru Manabu, Yoshida Akira, Ito Hiroaki, Hamatani Shigeharu, Kudo Shin-Ei

机构信息

Digestive Disease Center (Nikolas Eleftheriadis, Haruhiro Inoue, Haruo Ikeda, Roberta Maselli, Manabu Onimaru, Akira Yoshida, Hiroaki Ito, Shin-ei Kudo), Showa University Northern Yokohama Hospital, Japan.

Department of Pathology (Shigeharu Hamatani), Showa University Northern Yokohama Hospital, Japan.

出版信息

Ann Gastroenterol. 2014;27(3):267-269.

PMID:24975679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4073029/
Abstract

Endoscopic submucosal dissection (ESD) has become the treatment of choice for early gastric cancer. Accurate identification of tumor borders is crucial for curative ESD. Narrow band imaging magnification endoscopy (NBI-ME) has been effectively used for assessment of superficial gastric lesions; however, international experience in type "0-IIb" gastric lesions is limited. Successful endoscopic tissue characterization of laterally spreading type "0-IIb" early gastric cancer in a 74-year-old male with known type "0-IIa" lesion, using zoom NBI-ME, is reported. While the type "0-IIa" gastric lesion was clearly recognized by white light endoscopy and indigo carmine chromoendoscopy, the laterally spreading type "0-IIb" gastric cancer was only identified on the basis of NBI-ME malignant microvascular and mucosal microsurface pattern. Based on NBI-ME findings, accurate border marking approximately 1 mm apart from the demarcation line and complete ESD resection of both tumors was successfully succeeded. Recovery was uneventful. Histopathology showed moderately differentiated gastric adenocarcinoma in type "0-IIa" lesion and a small area of low-grade well-differentiated gastric adenocarcinoma in type "0-IIb" lesion. Conclusively, improved real-time optical identification of laterally spreading type "0-IIb" gastric lesion was achieved with NBI-ME.

摘要

内镜黏膜下剥离术（ESD）已成为早期胃癌的首选治疗方法。准确识别肿瘤边界对于根治性ESD至关重要。窄带成像放大内镜（NBI-ME）已有效地用于评估浅表性胃病变；然而，在“0-IIb”型胃病变方面的国际经验有限。本文报道了一名74岁男性，已知患有“0-IIa”型病变，使用放大NBI-ME成功地对侧向扩散型“0-IIb”早期胃癌进行了内镜组织特征分析。白光内镜和靛胭脂染色内镜能清晰识别“0-IIa”型胃病变，而侧向扩散型“0-IIb”胃癌仅根据NBI-ME的恶性微血管和黏膜微表面模式得以识别。基于NBI-ME的发现，在距分界线约1毫米处准确标记边界，并成功完成了两种肿瘤的ESD完整切除。恢复过程顺利。组织病理学显示，“0-IIa”型病变为中分化胃腺癌，“0-IIb”型病变为小面积低级别高分化胃腺癌。总之，NBI-ME实现了对侧向扩散型“0-IIb”胃病变更好的实时光学识别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/01775b1fd5d3/AnnGastroenterol-27-267-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/ca689a4c053a/AnnGastroenterol-27-267-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/15808059615c/AnnGastroenterol-27-267-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/01775b1fd5d3/AnnGastroenterol-27-267-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/ca689a4c053a/AnnGastroenterol-27-267-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/15808059615c/AnnGastroenterol-27-267-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28c/4073029/01775b1fd5d3/AnnGastroenterol-27-267-g003.jpg

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Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer.放大窄带成像比传统白光成像在诊断胃黏膜癌方面更准确。
Gastroenterology. 2011 Dec;141(6):2017-2025.e3. doi: 10.1053/j.gastro.2011.08.007. Epub 2011 Aug 19.
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Usefulness of magnifying narrow band imaging for assessing lateral tumor extent of early gastric cancer: a case report.
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Dig Endosc. 2011 May;23 Suppl 1:86-8. doi: 10.1111/j.1443-1661.2011.01111.x.
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Novel narrow-band imaging magnifying endoscopic classification for early gastric cancer.新型窄带成像放大内镜对早期胃癌的分类。
Dig Liver Dis. 2010 Oct;42(10):704-8. doi: 10.1016/j.dld.2010.03.013. Epub 2010 May 11.
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Endoscopic submucosal dissection of early gastric cancer.早期胃癌的内镜下黏膜下剥离术
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