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Surgical Endoscopy

, Volume 31, Issue 4, pp 1906–1913 | Cite as

Accuracy of diagnostic demarcation of undifferentiated-type early gastric cancer for magnifying endoscopy with narrow-band imaging: surgical cases

  • Yusuke HoriuchiEmail author
  • Junko Fujisaki
  • Noriko Yamamoto
  • Tomoki Shimizu
  • Masami Omae
  • Akiyoshi Ishiyama
  • Toshiyuki Yoshio
  • Toshiaki Hirasawa
  • Yorimasa Yamamoto
  • Tomohiro Tsuchida
  • Masahiro Igarashi
  • Hiroshi Takahashi
Article

Abstract

Background and aim

The usefulness of magnifying endoscopy with narrow-band imaging (ME-NBI) in undifferentiated-type early gastric cancers (UD-type EGCs) is unclear. This study investigated the accuracy of ME-NBI in the diagnostic demarcation.

Methods

Among UD-type EGCs that were initially surgically resected between June 2011 and August 2014 in this hospital, 74 lesions were studied that were preoperatively diagnosed with white-light imaging (WLI) or endoscopic ultrasonography as lesions for which endoscopic treatment was not indicated and found to be early gastric cancers by postoperative pathology. The demarcation line was marked on the most oral and anal sides with argon plasma coagulation using WLI and ME-NBI, and the diagnostic demarcation of cancer was defined as correct, if consistent with the results of postoperative pathology. The length of extension into the proliferative zone, distance between crypts and inflammatory cell infiltration (updated Sydney classification: USC) were compared between the correctly diagnosed and the misdiagnosed cases.

Results

The diagnosis was correct in 62 cases (83.8 %). The average distance between crypts in correctly diagnosed and misdiagnosed cases was approximately 1.9 and 1.3 times, respectively, that in normal mucosa (p < 0.0001). The accuracy of diagnosis was higher when atrophy and neutrophil and monocyte infiltration were mild according to the USC (p < 0.05). The additional use of ME-NBI improved the accuracy of diagnosis by 36.5 % compared with the use of WLI alone.

Conclusion

The use of ME-NBI in the preoperative diagnosis of the demarcation of cancer is useful to prevent postoperative positive surgical margins.

Keywords

Gastric cancer Surgery Endoscopy Endoscopic surgical procedure Laparoscopic surgery Carcinoma 

Notes

Compliance with ethical standards

Disclosures

Drs. Yusuke Horiuchi, Junko Fujisaki, Noriko Yamamoto, Tomoki Shimizu, Masami Omae, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida, Masahiro Igarashi and Hiroshi Takahashi have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Yusuke Horiuchi
    • 1
    Email author
  • Junko Fujisaki
    • 1
  • Noriko Yamamoto
    • 2
  • Tomoki Shimizu
    • 1
  • Masami Omae
    • 1
  • Akiyoshi Ishiyama
    • 1
  • Toshiyuki Yoshio
    • 1
  • Toshiaki Hirasawa
    • 1
  • Yorimasa Yamamoto
    • 1
  • Tomohiro Tsuchida
    • 1
  • Masahiro Igarashi
    • 1
  • Hiroshi Takahashi
    • 3
  1. 1.Department of GastroenterologyCancer Institute HospitalTokyoJapan
  2. 2.Department of PathologyCancer Institute HospitalTokyoJapan
  3. 3.Department of GastroenterologyShowa University Fujigaoka HospitalYokohamaJapan

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