The usefulness of magnifying endoscopy with narrow-band imaging to distinguish carcinoma in flat elevated lesions in the stomach diagnosed as adenoma by using biopsy samples

Masakatsu Nakamura, Tomoyuki Shibata, Tomomitsu Tahara, Daisuke Yoshioka, Masaaki Okubo, Yoshikazu Mizoguchi, Makoto Kuroda, Tomiyasu Arisawa, Ichiro Hirata

Research output: Contribution to journalArticle

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Abstract

Background: Therapeutic strategies for flat elevated (0-IIa) lesions in the stomach diagnosed as adenoma by biopsy are currently not established, because some difficulties have previously been reported in the evaluation of vascular patterns alone for the differential diagnosis between adenoma and carcinoma. Objective: We attempted to evaluate the 0-IIa lesions diagnosed as adenoma by using magnifying endoscopy with narrow-band imaging (MENBI) to distinguish them as either adenoma or carcinoma. Setting: Department of Gastroenterology, Fujita Health University. Patients: Fourteen adenomatous lesions (6 adenomas and 8 carcinomas confirmed postoperatively) diagnosed with preoperative biopsies from patients who had undergone endoscopic submucosal dissection were evaluated. Interventions: We selected 5 sites per lesion for MENBI. Selected sites were divided into superficial structures (SSs) and irregular microvascular patterns (IMVPs). Main Outcome Measurements: The rate of SSs and IMVPs in adenoma and carcinoma. Results: Significant SSs were tubular in the adenoma and unclear in the carcinoma. Regarding IMVP subcategories, (1) slight intrastructual irregular microvascular patterns (ISIMVPs) accounted for 97%, (2) severe ISIMVPs accounted for 0%, (3) fine networks accounted for 3%, and (4) corkscrews accounted for 0% of cases in the adenomas. The corresponding proportions in the carcinomas were (1) 40%, (2) 15%, (3) 45%, and (4) 0%. Severe ISIMVPs and fine networks were significant findings for carcinomas. Limitations: The number of cases was limited. Conclusions: Our combined evaluation method using MENBI offers the ability to establish proper therapeutic strategies for lesions that are difficult to identify as adenoma or carcinoma.

Original languageEnglish
Pages (from-to)1070-1075
Number of pages6
JournalGastrointestinal Endoscopy
Volume71
Issue number6
DOIs
Publication statusPublished - 01-05-2010

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Narrow Band Imaging
Adenoma
Endoscopy
Stomach
Carcinoma
Biopsy
Gastroenterology
Blood Vessels
Differential Diagnosis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Nakamura, Masakatsu ; Shibata, Tomoyuki ; Tahara, Tomomitsu ; Yoshioka, Daisuke ; Okubo, Masaaki ; Mizoguchi, Yoshikazu ; Kuroda, Makoto ; Arisawa, Tomiyasu ; Hirata, Ichiro. / The usefulness of magnifying endoscopy with narrow-band imaging to distinguish carcinoma in flat elevated lesions in the stomach diagnosed as adenoma by using biopsy samples. In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 6. pp. 1070-1075.
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abstract = "Background: Therapeutic strategies for flat elevated (0-IIa) lesions in the stomach diagnosed as adenoma by biopsy are currently not established, because some difficulties have previously been reported in the evaluation of vascular patterns alone for the differential diagnosis between adenoma and carcinoma. Objective: We attempted to evaluate the 0-IIa lesions diagnosed as adenoma by using magnifying endoscopy with narrow-band imaging (MENBI) to distinguish them as either adenoma or carcinoma. Setting: Department of Gastroenterology, Fujita Health University. Patients: Fourteen adenomatous lesions (6 adenomas and 8 carcinomas confirmed postoperatively) diagnosed with preoperative biopsies from patients who had undergone endoscopic submucosal dissection were evaluated. Interventions: We selected 5 sites per lesion for MENBI. Selected sites were divided into superficial structures (SSs) and irregular microvascular patterns (IMVPs). Main Outcome Measurements: The rate of SSs and IMVPs in adenoma and carcinoma. Results: Significant SSs were tubular in the adenoma and unclear in the carcinoma. Regarding IMVP subcategories, (1) slight intrastructual irregular microvascular patterns (ISIMVPs) accounted for 97{\%}, (2) severe ISIMVPs accounted for 0{\%}, (3) fine networks accounted for 3{\%}, and (4) corkscrews accounted for 0{\%} of cases in the adenomas. The corresponding proportions in the carcinomas were (1) 40{\%}, (2) 15{\%}, (3) 45{\%}, and (4) 0{\%}. Severe ISIMVPs and fine networks were significant findings for carcinomas. Limitations: The number of cases was limited. Conclusions: Our combined evaluation method using MENBI offers the ability to establish proper therapeutic strategies for lesions that are difficult to identify as adenoma or carcinoma.",
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The usefulness of magnifying endoscopy with narrow-band imaging to distinguish carcinoma in flat elevated lesions in the stomach diagnosed as adenoma by using biopsy samples. / Nakamura, Masakatsu; Shibata, Tomoyuki; Tahara, Tomomitsu; Yoshioka, Daisuke; Okubo, Masaaki; Mizoguchi, Yoshikazu; Kuroda, Makoto; Arisawa, Tomiyasu; Hirata, Ichiro.

In: Gastrointestinal Endoscopy, Vol. 71, No. 6, 01.05.2010, p. 1070-1075.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The usefulness of magnifying endoscopy with narrow-band imaging to distinguish carcinoma in flat elevated lesions in the stomach diagnosed as adenoma by using biopsy samples

AU - Nakamura, Masakatsu

AU - Shibata, Tomoyuki

AU - Tahara, Tomomitsu

AU - Yoshioka, Daisuke

AU - Okubo, Masaaki

AU - Mizoguchi, Yoshikazu

AU - Kuroda, Makoto

AU - Arisawa, Tomiyasu

AU - Hirata, Ichiro

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Therapeutic strategies for flat elevated (0-IIa) lesions in the stomach diagnosed as adenoma by biopsy are currently not established, because some difficulties have previously been reported in the evaluation of vascular patterns alone for the differential diagnosis between adenoma and carcinoma. Objective: We attempted to evaluate the 0-IIa lesions diagnosed as adenoma by using magnifying endoscopy with narrow-band imaging (MENBI) to distinguish them as either adenoma or carcinoma. Setting: Department of Gastroenterology, Fujita Health University. Patients: Fourteen adenomatous lesions (6 adenomas and 8 carcinomas confirmed postoperatively) diagnosed with preoperative biopsies from patients who had undergone endoscopic submucosal dissection were evaluated. Interventions: We selected 5 sites per lesion for MENBI. Selected sites were divided into superficial structures (SSs) and irregular microvascular patterns (IMVPs). Main Outcome Measurements: The rate of SSs and IMVPs in adenoma and carcinoma. Results: Significant SSs were tubular in the adenoma and unclear in the carcinoma. Regarding IMVP subcategories, (1) slight intrastructual irregular microvascular patterns (ISIMVPs) accounted for 97%, (2) severe ISIMVPs accounted for 0%, (3) fine networks accounted for 3%, and (4) corkscrews accounted for 0% of cases in the adenomas. The corresponding proportions in the carcinomas were (1) 40%, (2) 15%, (3) 45%, and (4) 0%. Severe ISIMVPs and fine networks were significant findings for carcinomas. Limitations: The number of cases was limited. Conclusions: Our combined evaluation method using MENBI offers the ability to establish proper therapeutic strategies for lesions that are difficult to identify as adenoma or carcinoma.

AB - Background: Therapeutic strategies for flat elevated (0-IIa) lesions in the stomach diagnosed as adenoma by biopsy are currently not established, because some difficulties have previously been reported in the evaluation of vascular patterns alone for the differential diagnosis between adenoma and carcinoma. Objective: We attempted to evaluate the 0-IIa lesions diagnosed as adenoma by using magnifying endoscopy with narrow-band imaging (MENBI) to distinguish them as either adenoma or carcinoma. Setting: Department of Gastroenterology, Fujita Health University. Patients: Fourteen adenomatous lesions (6 adenomas and 8 carcinomas confirmed postoperatively) diagnosed with preoperative biopsies from patients who had undergone endoscopic submucosal dissection were evaluated. Interventions: We selected 5 sites per lesion for MENBI. Selected sites were divided into superficial structures (SSs) and irregular microvascular patterns (IMVPs). Main Outcome Measurements: The rate of SSs and IMVPs in adenoma and carcinoma. Results: Significant SSs were tubular in the adenoma and unclear in the carcinoma. Regarding IMVP subcategories, (1) slight intrastructual irregular microvascular patterns (ISIMVPs) accounted for 97%, (2) severe ISIMVPs accounted for 0%, (3) fine networks accounted for 3%, and (4) corkscrews accounted for 0% of cases in the adenomas. The corresponding proportions in the carcinomas were (1) 40%, (2) 15%, (3) 45%, and (4) 0%. Severe ISIMVPs and fine networks were significant findings for carcinomas. Limitations: The number of cases was limited. Conclusions: Our combined evaluation method using MENBI offers the ability to establish proper therapeutic strategies for lesions that are difficult to identify as adenoma or carcinoma.

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