Hiraoka Yuji, Miura Yoshimasa, Osawa Hiroyuki, Nomoto Yoshie, Takahashi Haruo, Tsunoda Masato, Nagayama Manabu, Ueno Takashi, Lefor Alan Kawarai, Yamamoto Hironori
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
J Gastric Cancer. 2021 Jun;21(2):142-154. doi: 10.5230/jgc.2021.21.e13. Epub 2021 Jun 17.
Screening image-enhanced endoscopy for gastrointestinal malignant lesions has progressed. However, the influence of the color enhancement settings for the laser endoscopic system on the visibility of lesions with higher color contrast than their surrounding mucosa has not been established.
Forty early gastric cancers were retrospectively evaluated using color enhancement settings C1 and C2 for laser endoscopic systems with blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI). The visibilities of the malignant lesions in the stomach with the C1 and C2 color enhancements were scored by expert and non-expert endoscopists and compared, and the color differences between the malignant lesions and the surrounding mucosa were assessed.
Early gastric cancers mainly appeared orange-red on LCI and brown on BLI-bright or BLI. The surrounding mucosae were purple on LCI regardless of the color enhancement but brown or pale green with C1 enhancement and dark green with C2 enhancement on BLI-bright or BLI. The mean visibility scores for BLI-bright, BLI, and LCI with C2 enhancement were significantly higher than those with C1 enhancement. The superiority of the C2 enhancement was not demonstrated in the assessments by non-experts, but it was significant for experts using all modes. The C2 color enhancement produced a significantly greater color difference between the malignant lesions and the surrounding mucosa, especially with the use of BLI-bright (P=0.033) and BLI (P<0.001). C2 enhancement tended to be superior regardless of the morphological type, status, or the extension of intestinal metaplasia around the cancer.
Appropriate color enhancement settings improve the visibility of malignant lesions in the stomach and color contrast between the malignant lesions and the surrounding mucosa.
用于筛查胃肠道恶性病变的图像增强内镜技术已取得进展。然而，激光内镜系统的色彩增强设置对具有比周围黏膜更高色彩对比度的病变可视性的影响尚未明确。
回顾性评估了40例早期胃癌，使用蓝色激光成像（BLI）、BLI-明亮模式和联动成像（LCI）的激光内镜系统的色彩增强设置C1和C2。由专家和非专家内镜医师对胃部恶性病变在C1和C2色彩增强下的可视性进行评分并比较，并评估恶性病变与周围黏膜之间的色彩差异。
早期胃癌在LCI上主要呈现橙红色，在BLI-明亮模式或BLI上呈棕色。无论色彩增强如何，周围黏膜在LCI上呈紫色，但在BLI-明亮模式或BLI上，C1增强时呈棕色或浅绿色，C2增强时呈深绿色。C2增强时BLI-明亮模式、BLI和LCI的平均可视性评分显著高于C1增强时。非专家评估未显示C2增强的优势，但对使用所有模式的专家而言差异显著。C2色彩增强在恶性病变与周围黏膜之间产生了显著更大的色彩差异，尤其是使用BLI-明亮模式时（P=0.033）和BLI时（P<0.001）。无论形态类型、状态或癌周肠化生的范围如何，C2增强往往更具优势。
适当的色彩增强设置可提高胃部恶性病变的可视性以及恶性病变与周围黏膜之间的色彩对比度。
