Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
J Gastroenterol. 2019 May;54(5):396-406. doi: 10.1007/s00535-018-1515-6. Epub 2018 Oct 5.
Linked color imaging (LCI) increases the visibility of early gastric cancers, which may be associated with characteristic findings including background purple mucosae. These lesions are found in areas of chronic gastritis and surrounding mucosa. The aim of this study is to objectively characterize these lesions by color differences and color component values using LCI.
Fifty-two patients with early gastric cancer were enrolled. Color differences were calculated prospectively in malignant lesions and adjacent mucosa and compared with histological findings in resected specimens. Color component values of L*, a*, and b* were compared between purple and non-purple mucosae in areas of chronic gastritis. Based on histological findings, the accuracy of identifying gastric intestinal metaplasia was calculated.
Cancers and surrounding mucosa in 74% of lesions had similar colors using white light imaging (WLI), whereas purple mucosa surrounded part or all of cancers appearing orange-red, orange or orange-white using LCI. Greater color differences were seen using LCI compared to WLI, including flat-type cancers, leading to higher contrast. The surrounding purple mucosa corresponded histologically to intestinal metaplasia, facilitating the identification of malignant lesions. Forty lesions (83%) with purple mucosa and eight lesions (17%) with non-purple mucosa in areas of chronic gastritis were diagnosed as intestinal metaplasia by biopsy (83% accuracy). Color component values of purple mucosa differ significantly from those of non-purple mucosae.
LCI images have higher color contrast between early gastric cancers and surrounding mucosa compared to WLI. A characteristic purple color around gastric cancers using LCI represents intestinal metaplasia.
联合色彩成像（LCI）增加了早期胃癌的可见度，这可能与特征性发现有关，包括背景紫色黏膜。这些病变发生在慢性胃炎和周围黏膜区域。本研究的目的是通过 LCI 对这些病变的颜色差异和颜色成分值进行客观描述。
纳入 52 例早期胃癌患者。前瞻性计算恶性病变及其相邻黏膜的颜色差异，并与切除标本的组织学发现进行比较。比较慢性胃炎区域紫色和非紫色黏膜的 L*、a和 b颜色成分值。基于组织学发现，计算识别肠上皮化生的准确性。
74%的病变在白光成像（WLI）下具有相似的颜色，而 LCI 下橙色-红色、橙色或橙白色环绕部分或全部癌症的紫色黏膜。与 WLI 相比，LCI 下的颜色差异更大，包括平坦型癌症，对比度更高。周围的紫色黏膜在组织学上对应于肠上皮化生，有助于识别恶性病变。40 个病变（83%）伴紫色黏膜和 8 个病变（17%）伴非紫色黏膜的慢性胃炎区域被活检诊断为肠上皮化生（83%的准确性）。紫色黏膜的颜色成分值与非紫色黏膜有显著差异。
LCI 图像在早期胃癌及其周围黏膜之间的颜色对比度高于 WLI。LCI 下胃癌周围的特征性紫色代表肠上皮化生。
