Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Department of Endoscopy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan.
Gastric Cancer. 2022 Jul;25(4):761-769. doi: 10.1007/s10120-022-01299-5. Epub 2022 May 6.
With the improvement in endoscopic equipment functions, narrow-band imaging (NBI) for endoscopic observation of the stomach, which is an organ with a large lumen, is now feasible. Studies evaluating the NBI utility without magnifying endoscopy to diagnose the invasion extent for the demarcation line identification in early gastric cancer have not been reported. This study aimed to investigate the demarcation line diagnostic performance of NBI in early gastric cancer compared to that of white-light imaging (WLI) using prospectively collected consecutive specimens from early gastric cancer patients.
Thirty consecutive lesions were collected from patients who underwent endoscopic submucosal dissection for early gastric cancer. Next, 30 NBI and 30 WLI images, each with the same degree of gastric wall extension, angle, and layout for one lesion, were selected, and a total of 60 images were prepared for testing. The early gastric cancer invasion ranges in the endoscopic images was plotted using the web-developed software, and 264 independent endoscopists, unaware of the diagnosis, performed the web tests, with the concordance rates between the ranges of responses. After estimating the actual early gastric cancer invasion ranges, the NBI and WLI results were compared.
The concordance rates for NBI and WLI images were 43.1% (95% confidence interval [CI] 42.5-43.7%) and 37.2% (95% CI 36.6-37.7%), respectively, showing that the concordance rate for NBI was significantly higher than that for WLI.
This study suggested that NBI was more useful for identifying demarcation lines than WLI.
随着内镜设备功能的提高，现在可以对胃这种大腔器官进行窄带成像（NBI）内镜观察。目前尚无研究评估不使用放大内镜的 NBI 在诊断早期胃癌边界线方面的作用。本研究旨在通过前瞻性收集早期胃癌患者的连续标本，比较 NBI 与白光成像（WLI）在早期胃癌边界线诊断中的性能。
从接受内镜黏膜下剥离术治疗的早期胃癌患者中收集了 30 个连续病变。然后，选择了 30 张 NBI 和 30 张 WLI 图像，每张图像均为同一病变的相同胃壁延伸度、角度和布局，共制备 60 张图像进行测试。使用网络开发的软件绘制内镜图像中早期胃癌的侵犯范围，并邀请了 264 名独立的内镜医师进行网络测试，不了解诊断结果，根据他们的回答范围的一致性来评估。在估计了实际的早期胃癌侵犯范围后，比较了 NBI 和 WLI 的结果。
NBI 和 WLI 图像的一致性率分别为 43.1%（95%置信区间 [CI] 42.5-43.7%）和 37.2%（95% CI 36.6-37.7%），表明 NBI 的一致性率明显高于 WLI。
本研究表明，NBI 比 WLI 更有助于识别边界线。
