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Benefits of linked color imaging for recognition of early differentiated-type gastric cancer: in comparison with indigo carmine contrast method and blue laser imaging

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Abstract

Background and aim

Linked color imaging (LCI) is a novel endoscopy system, which enhances slight differences in mucosal color. However, whether LCI is more useful than other kinds of image-enhanced endoscopy (IEE) in recognizing early gastric cancer remains unclear. This study aimed to evaluate LCI efficacy compared with the indigo carmine contrast method (IC), and blue laser imaging-bright (BLI-brt) in early differentiated-type gastric cancer recognition.

Methods

We retrospectively analyzed early differentiated-type gastric cancer, which were examined by all four imaging techniques (white light imaging, IC, LCI, BLI-brt) at Asahi University Hospital from June 2014 to November 2018. Both subjective evaluation (using ranking score: RS) and objective evaluation (using color difference score: CDS) were adopted to quantify early differentiated-type gastric cancer recognition.

Results

During this period, 87 lesions were enrolled in this study. Both RS and CDS of LCI were significantly higher (p < 0.01) than those of IC and BLI-brt. Both RS and CDS of BLI-brt had no significant difference compared with those of IC. Subgroup analysis revealed that LCI was especially useful in post-Helicobacter pylori eradication patients and flat or depressed lesions compared with IC and BLI-brt.

Conclusions

LCI appears to be more beneficial for the recognition of early differentiated-type gastric cancer in endoscopic screenings than IC and BLI-brt from the middle to distant view.

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Acknowledgements

The authors wish to acknowledge Dr. S. Sugie, a professor in the Department of Diagnostic Pathology, Asahi University Hospital for the useful discussions. We also thank the anonymous reviewers for their helpful comments.

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Authors and Affiliations

  1. Department of Gastroenterology, Asahi University Hospital, 3-23 Hashimoto, Gifu, 500-8523, Japan

    Takeshi Yasuda, Nobuaki Yagi, Tatsushi Omatsu, Sadanari Hayashi, Yuki Nakahata, Yuriko Yasuda, Akihiro Obora & Takao Kojima

  2. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 465 Kawaramachi–Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Takeshi Yasuda, Yuji Naito & Yoshito Itoh

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  1. Takeshi Yasuda
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  2. Nobuaki Yagi
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Correspondence to Takeshi Yasuda.

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Disclosures

Yuji Naito received scholarship funds from EA Pharma. Co. Ltd. and collaboration　research funds from Fujifilm Medical Co., Ltd., and Taiyo Kagaku Co. Ltd. and has　been paid lecture fees by Mylan EPD Co., Takeda Pharma. Co. Ltd., Mochida Pharma.　Co. Ltd., EA Pharma. Co. Ltd., Otsuka Pharma. Co. Ltd., Nippon Kayaku Co. Ltd., and　Miyarisan Pharma. Co. Ltd. Yoshito Itoh received collaboration research fund from　Takeda Pharma. Co. Ltd., Daiichi Sankyo Co., Ltd, Otsuka Pharma. Co. Ltd., Eisai Co.　Ltd., and EA Pharma. Co. Ltd. and has been paid lecture fees by AstraZeneca K.K.　Neither the funding agency nor any outside organization participated in the study　design, and there are no competing interest. Drs. Takeshi Yasuda, Nobuaki Yagi, Tatsushi Omatsu, Yuriko Yasuda, Yuki Nakahata, Sadanari Hayashi, Akihiro Obora, and Takao Kojima have no conflicts of interest or financial ties to disclose.

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Yasuda, T., Yagi, N., Omatsu, T. et al. Benefits of linked color imaging for recognition of early differentiated-type gastric cancer: in comparison with indigo carmine contrast method and blue laser imaging. Surg Endosc 35, 2750–2758 (2021). https://doi.org/10.1007/s00464-020-07706-1

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