ABSTRACT
Objective To investigate the value of intervening part (IP)ratio under magnifying endoscopy with narrow-band imaging (ME-NBI )in the diagnosis of early gastric neoplastic lesions. Methods From September 2012 to May 2015 ,a total of 124 patients with suspected superficial gastric neoplastic lesions under white light endoscope (WLI)were enrolled,87 male with mean age of (63.2 ± 7.9)years old and 37 female with mean age of (62.6±8.2)years old.All the enrolled patients received precision endoscopy examination,which were observed under WLI at first followed by ME-NBI.Vessel, surface classification and IP features of the lesions under WLI and ME-NBI were recorded,and targeted biopsies were performed.Patients received endoscopic submucosal dissection (ESD)or surgery according to lesions features,histopathological results.Agreement rate between WLI,VS classification with IP ratio and the histopathological results were analyzed.Chi-square test was performed for rate comparision Receiver operator characteristic (ROC)curve was drawn to compare the diagnostic accuracy in early gastriccancer (EGC)between WLI and ME-NBI.Results Among the 124 patients,a total of 118 patients completed precision endoscopy examination.A total of 162 lesions were detected,and 161 of which were analyzed.A total of 84 low grade intraepithelial neoplasia (LGIN),63 high grade intraepithelial neoplasia (HGIN), seven mucosal cancer and seven submucosal cacinoma were detected. The incidences of demarcation line (32.1 %(27/84)vs 96.1 %(74/77)),irregular microsurface pattern (45 .2%(38/84)vs 87.0%(67/77)),irregular-microvascular pattern (16.7%(14/84)vs 62.3%(48/77 )),increased gland tube density (48.8%(41/84)vs 85 .7%(66/77 ))and increased microvessel density (21 .4%(18/84)vs 80.5 %(62/77))of non-cacinoma lesions (LGIN)were significantly lower than those of cacinoma lesions (including HGIN, mucosa cancer and submucosa cacinoma ), and the differences were statistically significant (χ2 =67.6,29.1 ,33.5 ,22.9,53.7,all P <0.05).The sensitivities of WLI and ME-NBI in EGC diagnosis were 89.6% and 94.8%,respectively;the specificities were 61 .9% and 83.3%, respectively,area under curve (AUC)were 0.84 and 0.93,respectively.The diagnostic accuracy of ME-NBI in early gastric cancer was higher than that of WLI,and the difference was statistically significant (χ2 =49.0, P <0.01).The sensitivities of vessel plus surface (VS)classification and VS classification with IP ratio were 90.9% and 94.8%,respectively;and the specificities were 81 .0% and 83.3%,respectively;AUC were 0.89 and 0.93,respectively.The diagnostic sensitivity of vessel classification with IP ratio was higher than that of simple vessel classification,and the differnce was statistically significant (χ2 =41 .0, P <0.01).Conclusion Compared with WLI,the diagnostic accuracy of ME-NBI is higher in gastric superficial neoplasia lesions,and IP ratio is helpful in diagnosis of gastric superficial neoplasia lesions.
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Background:Esophageal cancer is a commonly seen gastrointestinal malignancy. Early detection of superficial neoplastic lesions is critical for improving the prognosis. Therefore,it is of great importance to explore new endoscopic techniques for increasing the detection rate of early esophageal cancer. Aims:To assess the diagnostic accuracy of targeted biopsy guided by magnifying endoscopy combined with narrow-band imaging(ME-NBI)for suspected superficial lesions in esophagus. Methods:In a prospective cross-over designed trial,65 patients with suspected superficial lesions in esophagus detected by conventional gastroscopy were randomly assigned to group A and group B. Patients in group A received primary white light imaging(WLI)with Lugol’s staining followed by ME-NBI 4-6 weeks later,and patients in group B received primary ME-NBI followed by WLI with Lugol’s staining 4-6 weeks later. Random biopsy was performed in WLI with Lugol’s staining,while targeted biopsy was performed in ME-NBI based on Inoue’s intraepithelial papillary capillary loop (IPCL)classification. Results:A total of 58 patients completed the study and 68 lesions were eligible for statistical analysis. More biopsies were taken in WLI with Lugol’s staining than in ME-NBI(3. 7 vs. 2. 2 per lesion,P 0. 05). Conclusions:ME-NBI-guided targeted biopsy is superior to random biopsy by WLI with Lugol’s staining for detection of superficial neoplastic lesions in esophagus with higher sensitivity and less number of biopsy. It might benefit the follow-up endoscopic treatment.
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OBJECTIVE@#To investigate the roles of E-cadherin and beta-catenin play in the carcinogenesis and progression of laryngeal carcinoma.@*METHOD@#Immunohistochemistry staining (PicTure two steps method) was used to detect E-cadherin and beta-catenin proteins expression in laryngeal carcinomas and normal epithelia around tumors.@*RESULT@#In 60 laryngeal carcinomas, the abnormal expression rates of E-cadherin and beta-catenin were 55.00% and 66.67% respectively. The significant relationship was observed between abnormal E-cadherin and beta-catenin expression and differentiation, clinical stage and lymph node metastasis. There was a positive relationship between the expression of beta-catenin and E-cadherin in same sample.@*CONCLUSION@#The abnormal expression of E-cadherin and beta-catenin were closely related with differentiation, clinical stage, metastasis in laryngeal carcinoma.