Premium
Evaluation of gastric cancer diagnosis using new ultrathin transnasal endoscopy with narrow‐band imaging: Preliminary study
Author(s) -
Kawai Takashi,
Yanagizawa Kyosuke,
Naito Sakiko,
Sugimoto Hiroko,
Fukuzawa Masakatsu,
Gotoda Takuji,
Matsubayashi Jun,
Nagao Toshitaka,
Hoshino Sumito,
Tsuchida Akihiko,
Moriyasu Fuminori
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12797
Subject(s) - medicine , endoscope , endoscopy , lesion , narrow band imaging , magnification , mucosal lesions , stomach , radiology , diagnostic accuracy , nuclear medicine , pathology , gastroenterology , computer vision , computer science
Background and Aim The new developed ultrathin transnasal endoscope, the GIF ‐ XP 290 N , makes possible a resolving power similar to the GIF ‐ H 260 at a distance of 3 mm. In this study, using the GIF ‐ XP 290 N , we evaluated whether endoscopic diagnosis (discrimination between benign and malignant) of gastric lesions is possible using nonmagnified narrow‐band imaging ( NBI ) endoscopy. Methods The subjects were 255 consecutive patients who underwent screening of the gastrointestinal tract using new ultrathin transnasal endoscopy. Their average age was 65.2 ± 11.4 years. The male‐female ratio was 2.5:1. All cases were examined using conventional white‐light imaging ( WLI ) and nonmagnified NBI . When a depressed lesion was detected in the stomach, it was examined using WLI , then NBI close examination (at about 3 mm). We observed the mucosal structure of the lesion using close visualization with NBI . Concerning mucosal structural changes, we looked for a clear demarcation line between the lesion and the surrounding mucosa, and loss, irregularity, or nonuniformity of the lesion mucosal microsurface pattern. Results A total of 52 depressed lesions were examined. The histological diagnosis was cancer for 8 lesions, and noncancer for 44 lesions. WLI examination yielded a sensitivity of 50.0% (4/8), specificity of 63.6% (28/44), and accuracy 61.5% (32/52). On the other hand, NBI close examination yielded a sensitivity of 87.5% (7/8), specificity of 93.2% (41/44), and accuracy of 92.3% (48/52), significantly higher. Conclusion NBI close examination using ultrathin transnasal endoscopy enables mucosal diagnosis even without magnification and was considered to be an effective technique for improving endoscopic diagnosis.