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New diagnostic strategy using narrow-band imaging (NBI) during laparoscopic surgery for patients with colorectal cancer

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Abstract

Background

Accurate tumor stage diagnosis during laparoscopic surgery remains difficult. We clarify the impact of new diagnostic strategy using narrow-band imaging (NBI) during laparoscopic surgery for colorectal cancer compared with other strategies.

Methods

We defined angiogenesis (Ag) and fibrosis (Fib) grades using NBI laparoscopy (lap-NBI), and assessed the clinicopathological features associated with these grades for 67 patients with colorectal cancer who underwent surgery. We assessed vessel density and gray scale with computer software.

Results

NBI-Ag-grade and NBI-Fib-grade of the serosal surface of cancer lesions and peritoneal nodules correlated with vessel density and gray scale of those assessed by Image J computer software. NBI-Fib-grades of liver nodules also correlated with gray scale. NBI-Ag- grade and Fib-grade of the serosal surface of cancer lesions correlated with pathological depth of invasion. These NBI grades of pathological metastatic peritoneal nodules were higher than those of pathologically benign peritoneal nodules. NBI- Fib grades of pathological metastatic liver nodules were higher than those of pathologically benign liver nodules. In multivariate analysis, lap-NBI was associated with different diagnosis for T3, T4 and non-T3, and non-T4. Moreover, lap-NBI was associated with different diagnosis for T4 and non-T4. Predictive value for T4 by lap-NBI showed high sensitivity (85%) specificity (87%), positive predictive value (74%), negative predictive value (93%), and overall accuracy (87%). Sensitivity and overall accuracy of lap-NBI was superior to that of other diagnostic modalities.

Conclusion

We clarified the usefulness of the new diagnostic strategy using lap-NBI during laparoscopic surgery for colorectal cancer in comparison with other strategies.

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References

  1. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    Article  PubMed  Google Scholar 

  2. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, Colon cancer Laparoscopic or Open Resection Study Group (COLOR) (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    Article  PubMed  Google Scholar 

  3. Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparotomy for colon cancer. N Engl J Med 350:2050–2059

    Article  Google Scholar 

  4. Chang L, Stefanidis D, Richardson WS, Earle DB, Fanelli RD (2009) The role of staging laparoscopy for intraabdominal cancers: an evidence-based review. Surg Endosc 23(2):231–241

    Article  CAS  PubMed  Google Scholar 

  5. Ung L, Chua TC, Morris DL (2013) Peritoneal metastases of lower gastrointestinal tract origin: a comparative study of patient outcomes following cytoreduction and intraperitoneal chemotherapy. J Cancer Res Clin Oncol 139:1899–1908

    Article  CAS  PubMed  Google Scholar 

  6. Sugarbaker PH (2014) Update on the prevention of local recurrence and peritoneal metastases in patients with colorectal cancer. World J Gastroenterol 20:9286–9291

    PubMed  PubMed Central  Google Scholar 

  7. Hayashi N, Egami H, Kai M, Kurusu Y, Takano S, Ogawa M (1999) No-touch isolation technique reduces intraoperative shedding of tumor cells into the portal vein during resection of colorectal cancer. Surgery 125:369–374

    Article  CAS  PubMed  Google Scholar 

  8. Grande M, Milito G, Attina GM, Cadeddu F, Muzi MG, Nigro C, Farinon AM (2008) Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer. World J Surg Oncol 6:98. https://doi.org/10.1186/1477-7819-6-98

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tweedle EM, Chaudhri S, Azadeh B, Rooney PS (2006) Small, flat colorectal cancers in the UK population: an analysis of resected specimens. Colorectal Dis 9:641–646

    Article  Google Scholar 

  10. Elmas N, Killi RM, Sever A (2002) Colorectal carcinoma: radiological diagnosis and staging. Eur J Radiol 42:206–223

    Article  CAS  PubMed  Google Scholar 

  11. McCarthy PA, Rubesin SE, Levine MS, Langlotz CP, Laufer I, Furth EE, Herlinger H (1995) Colon cancer:morphology detected with barium enema examination versus histopahologic stage. Radiology 197:683–687

    Article  CAS  PubMed  Google Scholar 

  12. Gono K, Obi T, Yamaguchi M, Ohyama N, Machida H, Sano Y, Yoshida S, Hamamoto Y, Endo T (2004) Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 9:568–577

    Article  PubMed  Google Scholar 

  13. Cheong WF, Prahl SA, Welch AJ (1990) A review of the optical properties of bilogical tissues. IEEE J Quantum Eletcr 26:2166–2185

    Article  Google Scholar 

  14. Roggan A, Schadel D, Netz U, Ritz JP, Germer CT, Muller G (1999) The effect of preparation technique on the optical parameters of biological tissue. Appl Phys B 69:445–453

    Article  CAS  Google Scholar 

  15. Kikuchi H, Kamiya K, Hiramatsu Y, Miyazaki S, Yamamoto M, Ohta M, Baba S, Konno H (2014) Laparoscopic narrow-band imaging for the diagnosis of peritoneal metastasis in gastric cancer. Ann Surg Oncol 21(12):3954–3962

    Article  PubMed  Google Scholar 

  16. Sluiter NR, Vlek SL, Wijsmuller AR, Brandsma HT, de Vet HCW, van Grieken NCT, Kazemier G, Tuynman JB (2019) Narrow-band imaging improves detection of colorectal peritoneal metastases: a clinical study comparing advanced imaging techniques. Ann Surg Oncol 26(1):156–164

    Article  PubMed  Google Scholar 

  17. Aloisi A, Sonoda Y, Gardner GJ, Park KJ, Elliott SL, Zhou QC, Iasonos A, Abu-Rustum NR (2018) Prospective comparative study of laparoscopic narrow band imaging (NBI) versus standard imaging in gynecologic oncology. Ann Surg Oncol 25(4):984–990

    Article  PubMed  PubMed Central  Google Scholar 

  18. Schnelldorfer T, Jenkins RL, Birkett DH, Wright VJ, Price LL, Georgakoudi I (2016) Laparoscopic narrow band imaging for detection of occult cancer metastases: a randomized feasibility trial. Surg Endosc 30(4):1656–1661

    Article  PubMed  Google Scholar 

  19. Kim US, Kim SJ, Baek SH, Kim HK, Sohn YH (2011) Quantitative analysis of optic disc color. Korean J Ophthalmol 25:174–177

    Article  PubMed  PubMed Central  Google Scholar 

  20. Braun JD, Trinidad-Hernandez M, Perry D, Armstrong DG, Mills JL Sr (2013) Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia. J Vasc Surg 57:1213–1218

    Article  PubMed  Google Scholar 

  21. Yang SH, Lin JK, Lai CR, Chen CC, Li AF, Liang WY, Jiang JK (2004) Risk factors for peritoneal dissemination of colorectal cancer. J Surg Oncol 87:167–173

    Article  PubMed  Google Scholar 

  22. Koppe MJ, Boerman OC, Oyen WJ, Bleichrodt RP (2006) Peritoneal carcinomatosis of colorectal origin: incidence and current treatment strategies. Ann Surg 243:212–222

    Article  PubMed  PubMed Central  Google Scholar 

  23. Halvorsen TB, Seim E (1989) Association between invasiveness, inflammatory reaction, desmoplasia and survival in colorectal cancer. J Clin Pathol 42:162–166

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Dighe S, Blake H, Koh MD, Swift I, Arnaout A, Temple L, Barbachano Y, Brown G (2010) Accuracy of multidetector computed tomography in identifying poor prognostic factors in colonic cancer. Br J Surg 97:1407–1415

    Article  CAS  PubMed  Google Scholar 

  25. Haji A, Ryan S, Bjarnason I, Donaldson N, Papagrigoriadis S (2012) Colonoscopic high frequency mini-probe ultrasound is more accurate than conventional computed tomography in the local staging of colonic cancer. Colorectal Dis 14:953–959

    Article  CAS  PubMed  Google Scholar 

  26. Benson AB 3rd, Schrag D, Somerfield MR, Cohen AM, Figueredo AT, Flynn PJ, Krzyzanowska MK, Maroun J, McAllister P, Van Cutsem E, Brouwers M, Charette M, Haller DG (2004) American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 22:3408–3419

    Article  PubMed  Google Scholar 

  27. Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, Covey A, Dilawari RA, Early DS, Enzinger PC, Fakih MG, Fleshman J Jr, Fuchs C, Grem JL, Kiel K, Knol JA, Leong LA, Lin E, Mulcahy MF, Rao S, Ryan DP, Saltz L, Shibata D, Skibber JM, Sofocleous C, Thomas J, Venook AP, Willett C, Network NCC (2009) NCCN clinical practice guidelines in oncology: colon cancer. J Natl Compr Cancer Netw 7:778–831

    Article  Google Scholar 

  28. Saif MW, Elfiky A, Salem RR (2007) Gastrointestinal perforation due to bevacizumab in colorectal cancer. Ann Surg Oncol 14:1860–1869

    Article  PubMed  Google Scholar 

  29. Nekarda H, Gess C, Stark M, Mueller JD, Fink U, Schenck U, Siewert JR (1999) Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma. Br J Cancer 79:611–619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Kodera Y, Nakanishi H, Ito S, Yamamura Y, Kanemitsu Y, Shimizu Y, Hirai T, Yasui K, Kato T, Tatematsu M (2002) Quantitative detection of disseminated free cancer cells in peritoneal washes with real-time reverse transcriptase-polymerase chain reaction: a sensitive predictor of outcome for patients with gastric carcinoma. Ann Surg 235:499–506

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tinelli R, Surico D, Leo L, Pinto V, Surico N, Fusco A, Cicinelli MV, Meir YJ, Cicinelli E (2011) Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia: a multicenter controlled study. Menopause 18(9):1026–1029

    Article  PubMed  Google Scholar 

  32. Oba S, Tnanaka S, Sano Y, Oka S, Chayama K (2011) Current status of narrow-band imaging magnifying colonoscopy for colorectal neoplasia in Japan. Digestion 83:167–172

    Article  CAS  PubMed  Google Scholar 

  33. Kanao H, Tanaka S, Oka S, Hirata M, Yoshida S, Chayama K (2009) Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc 70:522–531

    Google Scholar 

  34. Kuroda K, Kitade M, Kikuchi I, Kumakiri J, Matsuoka S, Tokita S, Kuroda M, Takeda S (2011) A new instrument: a flexible hysteroscope with narrow band imaging system: optical quality comparison between a flexible and a rigid hysteroscope. Minim Invasive Ther Allied Technol 20:263–266

    Article  PubMed  Google Scholar 

  35. Weidner N (1995) Intratumor microvessel density as a prognostic factor in cancer. Am J Pathol 147:9–19

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Torres S, Bartolomé RA, Mendes M, Barderas R, Fernandez-Aceñero MJ, Peláez-García A, Peña C, Lopez-Lucendo M, Villar-Vázquez R, de Herreros AG, Bonilla F, Casal JI (2013) Proteome profiling of cancer-associated fibroblasts identifies novel proinflammatory signatures and prognostic markers for colorectal cancer. Clin Cancer Res 19(21):6006–6019

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We acknowledge editing and proofreading by Benjamin Phillis from the Clinical Study Support Center at Wakayama Medical University.

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan

    Yoh Takei, Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Watanabe, Koichi Tamura, Yasuyuki Mitani, Junji Ieda, Hiromitsu Iwamoto, Yuki Mizumoto & Hiroki Yamaue

  2. Departments of Human Pathology and Diagnostic Pathology, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan

    Yoshifumi Iwahashi

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  1. Yoh Takei
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Correspondence to Tsukasa Hotta.

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Drs. Yoh Takei, Tsukasa Hotta, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Watanabe, Koichi Tamura, Yasuyuki Mitani, Junji Ieda, Hiromitsu Iwamoto, Yuki Mizumoto, Yoshifumi Iwahashi, and Hiroki Yamaue have no conflicts of interest or financial ties to disclose.

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Takei, Y., Hotta, T., Takifuji, K. et al. New diagnostic strategy using narrow-band imaging (NBI) during laparoscopic surgery for patients with colorectal cancer. Surg Endosc 36, 8843–8855 (2022). https://doi.org/10.1007/s00464-022-09313-8

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