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Prediction of colorectal tumor grade and invasion depth through narrow-band imaging scoring

World Journal of Gastroenterology 2018年第42期24卷 4809-4820页

作者： Yasuhiko Maeyama Keiichi Mitsuyama Tetsuhiro Noda Shiuchiro Nagata Tsutomu Nagata Shinichiro Yoshioka Hikaru Yoshida michita mukasa Hiroaki Sumie Hiroshi Kawano Jun Akiba Yuko Araki Tatsuyuki Kakuma Osamu Tsuruta Takuji Torimura Division of Gastroenterology Department of MedicineKurume University School of Medicine Department of Gastroenterology St.Mary’s HospitalKurume Department of Diagnostic Pathology Kurume University Hospital Biostatistics Center Kurume University School of Medicine

AIM To determine the usefulness of assigning narrow-band imaging(NBI) scores for predicting tumor grade and invasion depth in colorectal tumors.METHODS A total of 161 colorectal lesions were analyzed from138 patients who underwent endoscopic or surgical resection after conventional colonoscopy and magnifying endoscopy with NBI. The relationships between the surface and vascular patterns of the lesions, as visualized with NBI, and the tumor grade and depth of submucosa(SM) invasion were determined histopathologically.Scores were assigned to distinct features of the surface microstructures of tubular and papillary-type lesions.Using a multivariate analysis, a model was developed for predicting the tumor grade and depth of invasion based on NBI-finding scores.RESULTS NBI findings that correlated with a high tumor grade were associated with the "regular/irregular"(P < 0.0001)surface patterns and the "avascular area" pattern(P =0.0600). The vascular patterns of "disrupted vessels"(P = 0.0714) and "thick vessels"(P = 0.0133) but none of the surface patterns were associated with a depth of invasion of ≥ 1000 μm. In our model, a total NBIfinding score ≥ 1 was indicative of a high tumor grade(sensitivity: 0.97; specificity: 0.24), and a total NBIfinding score ≥ 9(sensitivity: 0.56; specificity: 1.0) was predictive of a SM invasion depth ≥ 1000 μm. Scores less than these cutoff values signified adenomas and a SM invasion depth < 1000 μm, respectively. Associations were also noted between selected NBI findings and tumor tissue architecture and histopathology.CONCLUSION Our multivariate statistical model for predicting tumor grades and invasion depths from NBI-finding scores may help standardize the diagnosis of colorectal lesions and inform therapeutic strategies.

关键词： Colorectal cancer Magnifying narrow-band imaging Score Surface pattern Vascular pattern

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Clinical characteristics and management of gastric tube cancer with endoscopic submucosal dissection

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World Journal of Gastroenterology 2015年第3期21卷 919-925页

作者： michita mukasa Hidetoshi Takedatsu Ken Matsuo Hiroaki Sumie Hikaru Yoshida Atsushi Hinosaka Yasutomo Watanabe Osamu Tsuruta Takuji Torimura Division of Gastroenterology Department of MedicineKurume University School of Medicine67 Asahi-machiKurumeFukuoka 830-0011Japan

AIM:To identify the characteristics of gastric tube cancer(GTC) and the complications associated with endoscopic submucosal dissection(ESD) for GTC.METHODS:Between 2007 and 2012,11 individualswith early gastric cancer in the reconstructed gastric tube after esophagectomy who underwent ESD in this hospital were studied.The characteristics of GTC were identified,and the complications of ESD for GTC were analyzed at three phases:preoperative,intraoperative,and postoperative.RESULTS:A total of 11 consecutive patients with 11 GTCs were selected for this study.All cases underwent en bloc resections by ESD.The median procedure time was 142 min.The average GTC diameter was 26.1 mm,and the average size of the resected lesions was 45.5 mm.The histopathological diagnosis in all cases was a differentiated adenocarcinoma.In the preoperative phase,anastomotic strictures(5/11,45%) and food residues(4/11,36.4%) in the gastric tube were the main complications.In the intraoperative phase,bleeding was observed in 5 cases(45%).The postoperative complications observed were delayed bleeding in 2 cases(18.2%) and stenosis in one case(9.1%).The case with stenosis was successfully treated using endoscopic balloon dilatation.CONCLUSION:Minor complications were frequently observed.However,all GTCs underwent en bloc resection with ESD without any serious complications.ESD is considered a useful treatment for GTC.

关键词： Gastric tube cancer Endoscopic submucosal dissecti

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Diagnosis of early gastric cancer using narrow band imaging and acetic acid

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World Journal of Gastroenterology 2015年第4期21卷 1268-1274页

作者： Ken Matsuo Hidetoshi Takedatsu michita mukasa Hiroaki Sumie Hikaru Yoshida Yasutomo Watanabe Jun Akiba Keita Nakahara Osamu Tsuruta Takuji Torimura Division of Gastroenterology Department of MedicineKurume University School of MedicineFukuoka 830-0011Japan Department of Pathology Kurume University School of MedicineFukuoka 830-0011Japan

AIM: To determine whether the endoscopic findings of depressed-type early gastric cancers(EGCs) could precisely predict the histological type.METHODS: Ninety depressed-type EGCs in 72 patients were macroscopically and histologically identified. We evaluated the microvascular(MV) and mucosal surface(MS) patterns of depressed-type EGCs using magnifying endoscopy(ME) with narrow-band imaging(NBI)(NBI-ME) and ME enhanced by 1.5% acetic acid, respectively. First, depressed-type EGCs were classified according to MV pattern by NBI-ME. Subsequently, EGCs unclassified by MV pattern were classified according to MS pattern by enhanced ME(EME) images obtained from the same angle.RESULTS: We classified the depressed-type EGCs into the following 2 MV patterns using NBI-ME: a fine-network pattern that indicated differentiated adenocarcinoma(25/25, 100%) and a corkscrew pattern that likely indicated undifferentiated adenocarcinoma(18/23, 78.3%). However, 42 of the 90(46.7%) lesions could not be classified into MV patterns by NBI-ME. These unclassified lesions were then evaluated for MS patterns using EME, which classified 33(81.0%) lesions as MS patterns, diagnosed as differentiated adenocarcinoma. As a result, 76 of the 90(84.4%) lesions were matched with histological diagnoses using a combination of NBI-ME and EME.CONCLUSION: A combination of NBI-ME and EME was useful in predicting the histological type of depressedtype EGC.

关键词： Narrow band imaging Magnifying endoscopy Acetic ac

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