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Objective:To analyze and compare the features of undifferentiated-typed early gastric cancer (UD-EGC) and gastric mucosa-associated lymphoid tissue(MALT) lymphoma under white light endoscopy (WLE) and magnifying endoscopy-narrow band imaging (ME-NBI).Methods:Data of patients with complete endoscopic images of WLE and ME-NBI in Shanghai General Hospital, Shanghai Jiao Tong University from March 2015 to July 2019 were retrospectively analyzed.Twenty-six UD-EGC patients and seven gastric MALT lymphoma patients in ⅠE1 stage were included, and the characteristics of the two diseases under WLE and ME-NBI were compared and summarized.Results:There were no significant differences in age, sex or infiltration depth of lesions between the two groups.Under WLE, UD-EGC was often manifested as a single lesion located in the lower part of the stomach, with unclear lesion boundaries. While MALT lymphoma lesions were mostly multifocal with clear boundaries, located in the middle of the stomach. Under ME-NBI, the microsurface pattern of UD-EGC showed dilation or disappearance of areas between the recesses, and the spiral microvascular pattern. However, the microsurface pattern of MALT lymphomas were characterized by " cross-road traffic sign" , " pebble sign" , and the presentation of residual glandular duct at the lesion was similar to that of Helicobacter pylori ( HP)-related gastritis. Furthermore, the microvascular pattern of MALT lymphomas often showed " tree like appearance (TLA)" . After HP eradication therapy, the morphology of microsurface pattern and microvascular pattern in the original lesion area gradually returned to normal. Conclusion:UD-EGC and gastric MALT lymphoma showed particular features in the number, site and boundary under WLE, and they showed significantly different microsurface pattern and microvascular pattern under ME-NBI. Differentiation of the two diseases will help reduce the risk of missed diagnosis and misdiagnosis.
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Objective@#To evaluate optical coherence tomography(OCT)for predicting invasion depth of early esophageal cancer(EEC) and to compare OCT and magnifying endoscopy-narrow band imaging (ME-NBI)in clinical performance.@*Methods@#Twenty-eight patients who were diagnosed with EEC and accepted OCT and ME-NBI before endoscopic submucosal dissection(ESD)were enrolled in this prospective study. On the basis of OCT and ME-NBI images, real-time prediction of EEC invasion depth was conducted. Postoperative pathological results were taken as golden standard to compare the accuracy of OCT and ME-NBI in evaluation of EEC invasion depth. The procedure time and incidence of complications during evaluation process were also analyzed.@*Results@#The overall accuracy of OCT and ME-NBI in predicting invasion depth of 28 EEC patients were 67.9% (19/28) and 75.0% (21/28) respectively, with no significant difference(P>0.05). The accuracy of OCT and ME-NBI in distinguishing lesions located in epithelium/lamina propria mucosa (EP/LPM) lesions were 78.9%(15/19) and 68.4% (13/19), with no significant difference(P>0.05). The procedure time of OCT was significantly shorter than that of ME-NBI (6.0±2.9 min VS 16.3±5.4 min, P<0.001).@*Conclusion@#The ability of OCT to predict invasion depth of EEC and distinguish lesions located in the EP/LPM is comparable with that of ME-NBI. Besides, OCT requires shorter procedure time for evaluation.
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Objective@#To investigate the effects of Helicobacter pylori (HP) radical treatment on diagnosis of early gastric cancer using conventional white light endoscopy (WLE), chromoendoscopy of indigo carmine dye added to acetic acid, and magnifying endoscopy with narrow band imaging (ME-NBI).@*Methods@#Between January 2013 and March 2018, patients without HP (successful cured before six months) or with HP (no radical treatment for HP in recent 6 months), who underwent endoscopy examinations in the Department of Gastroenterology of Ezhou Hospital, People′s Hospital of Wuhan University or the Department of Gastroenterology of Union Hospital, Tongji Medical College Huazhong University of Science and Technology were enrolled in the study. Endoscopy examinations were performed according to the order of conventional WLE, chromoendoscopy using indigo carmine dye added to acetic acid, and ME-NBI. Among the patients finally diagnosed as early gastric cancer by histopathology, 120 patients without HP and 120 patients with HP were continuously collected, and included in the radical treatment group and the non-radical treatment group, respectively. Diagnostic reliabilities of WLE, chromoendoscopy, and ME-NBI for early gastric cancer between the two groups were statistically analyzed.@*Results@#There were no statistical differences between the two groups in terms of hospital source (χ2=2.637, P=0.104), gender composition (χ2=0.074, P=0.785), mean age (t=0.582, P=0.561), and lesion morphology (χ2=0.179, P=0.914). The detection rates of early gastric cancer in the radical treatment group using WLE [75.0% (80/120) VS 81.7% (98/120), χ2=7.046, P=0.008], chromoendoscopy [57.5% (69/120) VS 93.3% (112/120), χ2=41.554, P<0.001], and ME-NBI [90.0% (108/120) VS 98.3% (118/120), χ2=7.585, P=0.006] were significantly lower than those in the non-radical treatment group. In the radical treatment group, chromoendoscopy had the lowest detection rate of early gastric cancer, followed by WLE (χ2=2.142, P=0.143) and ME-NBI (χ2=32.736, P<0.001), while ME-NBI had the highest detection rate of early gastric cancer, which higher than that of WLE (χ2= 19.247, P<0.001).@*Conclusion@#The diagnosis of early gastric cancer by WLE, chromoendoscopy using the indigo carmine dye added to acetic acid and ME-NBI becomes more difficult after radical treatment of HP. Among the above three endoscopic methods, ME-NBI has the highest diagnostic efficacy, and becomes the first choice for the clinical diagnosis of early gastric cancer after radical treatment of HP.
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Objective To investigate the effects of Helicobacter pylori (HP) radical treatment on diagnosis of early gastric cancer using conventional white light endoscopy ( WLE ) , chromoendoscopy of indigo carmine dye added to acetic acid, and magnifying endoscopy with narrow band imaging (ME-NBI). Methods Between January 2013 and March 2018, patients without HP (successful cured before six months) or with HP ( no radical treatment for HP in recent 6 months ) , who underwent endoscopy examinations in the Department of Gastroenterology of Ezhou Hospital, People's Hospital of Wuhan University or the Department of Gastroenterology of Union Hospital, Tongji Medical College Huazhong University of Science and Technology were enrolled in the study. Endoscopy examinations were performed according to the order of conventional WLE, chromoendoscopy using indigo carmine dye added to acetic acid, and ME-NBI. Among the patients finally diagnosed as early gastric cancer by histopathology, 120 patients without HP and 120 patients with HP were continuously collected, and included in the radical treatment group and the non-radical treatment group, respectively. Diagnostic reliabilities of WLE, chromoendoscopy, and ME-NBI for early gastric cancer between the two groups were statistically analyzed. Results There were no statistical differences between the two groups in terms of hospital source (χ2 =2. 637, P=0. 104) , gender composition (χ2=0. 074, P=0. 785) , mean age ( t=0. 582, P=0. 561) , and lesion morphology (χ2 = 0. 179, P= 0. 914 ) . The detection rates of early gastric cancer in the radical treatment group using WLE [ 75. 0％( 80/120 ) VS 81. 7％( 98/120 ) ,χ2 = 7. 046, P = 0. 008 ] , chromoendoscopy [ 57. 5％( 69/120 ) VS 93. 3％( 112/120 ) ,χ2 =41. 554, P<0. 001 ] , and ME-NBI [ 90. 0％( 108/120) VS 98. 3％( 118/120) ,χ2=7. 585, P=0. 006] were significantly lower than those in the non-radical treatment group. In the radical treatment group, chromoendoscopy had the lowest detection rate of early gastric cancer, followed by WLE (χ2=2. 142, P=0. 143) and ME-NBI (χ2=32. 736, P<0. 001) , while ME-NBI had the highest detection rate of early gastric cancer, which higher than that of WLE (χ2= 19.247, P<0.001). Conclusion The diagnosis of early gastric cancer by WLE, chromoendoscopy using the indigo carmine dye added to acetic acid and ME-NBI becomes more difficult after radical treatment of HP. Among the above three endoscopic methods, ME-NBI has the highest diagnostic efficacy, and becomes the first choice for the clinical diagnosis of early gastric cancer after radical treatment of HP.
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Objective To investigate the clinical utility of magnifying endoscopy combined with nar-row-band imaging( ME-NBI)and endoscopic ultrasonography( EUS)in predicting the depth of early eso-phageal cancer. Methods Sixty-eight patients with early esophageal cancer after gastroscopic and pathological diagnosis were enrolled in Jiangsu Provincal Hospital of Traditional Chinese Medicine from January 2017 to May 2018,ME-NBI and EUS were performed preoperatively to determine the depth of lesion infiltration respectively, the accuracies of the two methods were calculated by referring to the postoperative pathology,and the McNemar test and Kappa test were used for comparison. Results The lesion confined to shallow mucosa and submucosa superficial layer was confirmed in 57 patients by postoperative pathology,submucosa superficial below in 11 pa-tients. Compared with that of histology,the ability of assessment of the invasion depth was moderately consistent with ME-NBI(McNemar test P = 0. 508;Kappa = 0. 560,P < 0. 001),not with EUS(McNemar test P =0. 019;Kappa = 0. 266,P = 0. 015). The accuracy for assessing invasion depth of early esophageal cancer was 86. 8％(59 / 68)by ME-NBI,72. 1％(49 / 68)by EUS,respectively,with statistically significant difference (McNemar test P = 0. 015;Kappa = 0. 258,P = 0. 026). Conclusion ME-NBI and EUS can help to deter-mine the infiltration level of early esophageal cancer. The accuracy of ME-NBI is higher,which is of high value for the formulation of surgical plans for patients.
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Objective To evaluate the clinical value of JNET classification using magnifying endoscopy with narrow-band imaging(ME-NBI)on diagnosis of colorectal neoplastic lesions. Methods A total of 110 colorectal neoplastic lesions detected by conventional colonoscopy were assessed by ME-NBI,and the histology was predicted according to characteristics of vessel pattern and surface pattern with JNET classification and Kudo classification,respectively. The results were compared with actual histologic findings of these lesions. Results The diagnostic sensitivity, specificity, positive predictive value, negative predictive value,and accuracy of overall JNET classification with ME-NBI for colorectal neoplastic lesions was 96.2%(75/78),93.8%(30/32),97.4%(75/77),90.9%(30/33), and 95.5%(105/110), respectively. The corresponding indicators of overall Kudo classification with ME-NBI was 92.3%(72/78), 81.3%(26/32),92.3%(72/78),81.3%(26/32),and 89.1%(98/110),respectively,with no significant difference compared to JNET classification(P=0.077). Diagnostic accuracy of JNET classification was 92.3%(36/39)in the polyps with diameter of 1 to 5 mm,93.8%(15/16)in the polyps with diameter of 6 to 10 mm,98.2%(54/55)in the polyps with diameter more than 10 mm, and those diagnostic accuracies had no significant difference(P=0.345). Conclusion JNET classification with ME-NBI is effective in distinguishing neoplastic from non-neoplastic colorectal lesions.