Dohi Osamu, Yagi Nobuaki, Majima Atsushi, Horii Yusuke, Kitaichi Tomoko, Onozawa Yuriko, Suzuki Kentaro, Tomie Akira, Kimura-Tsuchiya Reiko, Tsuji Toshifumi, Yamada Nobuhisa, Bito Nobukatsu, Okayama Tetsuya, Yoshida Naohisa, Kamada Kazuhiro, Katada Kazuhiro, Uchiyama Kazuhiko, Ishikawa Takeshi, Takagi Tomohisa, Handa Osamu, Konishi Hideyuki, Naito Yuji, Yanagisawa Akio, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Gastric Cancer. 2017 Mar;20(2):297-303. doi: 10.1007/s10120-016-0620-6. Epub 2016 Jun 13.
Blue laser imaging (BLI) is a new image-enhanced endoscopy technique that utilizes a laser light source developed for narrow-band light observation. The aim of this study was to evaluate the usefulness of BLI for the diagnosis of early gastric cancer.
This single center prospective study analyzed 530 patients. The patients were examined with both conventional endoscopy with white-light imaging (C-WLI) and magnifying endoscopy with BLI (M-BLI) at Kyoto Prefectural University of Medicine between November 2012 and March 2015. The diagnostic criteria for gastric cancer using M-BLI included an irregular microvascular pattern and/or irregular microsurface pattern, with a demarcation line according to the vessel plus surface classification system. Biopsies of the lesions were taken after C-WLI and M-BLI observation. The primary end point of this study was to compare the diagnostic performance between C-WLI and M-BLI.
We analyzed 127 detected lesions (32 cancers and 95 non-cancers). The accuracy, sensitivity, and specificity of M-BLI diagnoses were 92.1, 93.8, and 91.6 %, respectively. On the other hand, the accuracy, sensitivity, and specificity of C-WLI diagnoses were 71.7, 46.9, and 80.0 %, respectively.
M-BLI had improved diagnostic performance for early gastric cancer compared with C-WLI. These results suggested that the diagnostic effectiveness of M-BLI is similar to that of magnifying endoscopy with narrow-band imaging (M-NBI).
蓝光成像（BLI）是一种新型的图像增强内镜技术，它利用为窄带光观察而开发的激光光源。本研究的目的是评估BLI在早期胃癌诊断中的实用性。
这项单中心前瞻性研究分析了530例患者。2012年11月至2015年3月期间，患者在京都府立医科大学接受了白光成像的传统内镜检查（C-WLI）和BLI的放大内镜检查（M-BLI）。使用M-BLI诊断胃癌的标准包括不规则微血管形态和/或不规则微表面形态，并根据血管加表面分类系统划分边界线。在C-WLI和M-BLI观察后对病变进行活检。本研究的主要终点是比较C-WLI和M-BLI之间的诊断性能。
我们分析了127个检测到的病变（32个癌症和95个非癌症）。M-BLI诊断的准确性、敏感性和特异性分别为92.1%、93.8%和91.6%。另一方面，C-WLI诊断的准确性、敏感性和特异性分别为71.7%、46.9%和80.0%。
与C-WLI相比，M-BLI对早期胃癌的诊断性能有所提高。这些结果表明，M-BLI的诊断效果与窄带成像放大内镜检查（M-NBI）相似。
