A prospective study of optical coherence tomography for predicting invasion depth of early esophageal cancer / 中华消化内镜杂志

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.

Accuracy of magnifying endoscopy with narrow-band imaging for detecting early esophageal cancer invasion depth：a meta-analysis / 中国内镜杂志

Objective To evaluate the accuracy of magnifying endoscopy with narrow-band imaging (ME-NBI) for detecting early esophageal cancer invasion depth. Methods We searched Embase, Pubmed, Web of Science, Cochrane Library, CBM, CNKI, Wanfang and VIP databases from inception to Feb.2016. Domestic articles related to the accuracy of ME-NBI detecting the early esophageal cancer invasion depth were collected comprehensively. The quality of the papers was evaluated by quality assessment of diagnostic accuracy studies (QUADAS). Data analysis was conducted by Stata 12.0 software. Results Seven group data from six studies including 319 patients with 366 lesions met the inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, SROC area under the curve and DOR were 93.8 % (95 % CI: 0.886~0.967), 75.2 % (95 % CI: 0.658~0.827), 3.779 (95 % CI: 2.685 ~ 5.318), 0.083 (95 % CI: 0.044~0.155), 0.80 (95 % CI: 0.770~0.840) and 45.658 (95 % CI:21.006~99.240). Conclusions The results suggest that ME-NBI may be an effective tool for detecting invasion depth of early esophageal cancer, which plays an important role in clinical selection of surgical approach and treatment.

Endoscopic Assessment of Colorectal Cancer with Superficial or Deep Submucosal Invasion Using Magnifying Colonoscopy

Among early colorectal carcinoma, endoscopic treatment is generally indicative for cases with intramucosal to submucosal (SM) superficial invasion, because cases with SM deep invasion should be treated surgically due to the risk of lymph node metastasis. It is important, therefore, to distinguish between superficial and deep SM invasion in early colorectal carcinoma prior to treatment. In this review we assessed the clinical usefulness and knack of pit pattern and narrow band imaging (NBI) diagnosis using magnifying observation. VN type pit pattern, type C3 in NBI Hiroshima classification and NBI type 3 in NBI international colorectal endoscopic (NICE) classification are useful predictors of SM deep invasion. In NBI magnifying observation evaluation of both the vascular pattern and surface pattern are important. We have to use pit pattern diagnosis and NBI magnifying diagnosis as the situation demands with the knowledge of both advantage and disadvantage in each diagnostic method.

A novel endoscopic classification system to determine the invasion depth of early esophageal cancer / 中华消化内镜杂志

Objective To develop a novel endoscopic classification system to determine the invasion depth of early esophageal cancer.Methods The esophageal lesion was endoscopicaUy stained with Lugol's iodine first,then methylene blue.According to the growth pattern,height and cup depth under endoscope,the lesions were classified into 5 types,including surface diffusion growth,intra-lumen growth,intra-wall growth,bi-direction growth and mix growth types.The lesions were then removed by endoscopic mucosa reection or surgery,the precise invasion depth of the lesion was determined pathologically and the results were compared with the endoscopy classification.Results The data of 44 cases of esophageal mucosal cancer and 34 cases of esophageal sub-mueosal cancer were included.With the criteria of mucosal cancer as surface diffusion growth,intra-lumen growth <5mm,bi-direetion growth <2mm and intra-wall growth <0.5 mm,the diagnostic specificity was 89.1%(41/46) and sensitivity was 93.2%(41/44).With the criteria of submucosal cancer as intra-lumen growth≥5 mm,hi-direction growth≥2mm,intra-wall growth≥0.5 mm and mix growth type,the diagnostic specificity was 90.6%(29/32) and sensitivity was 85.3%(29/34).The overall diagnostic accuracy in differentiating esophageal mucosal cancer from esophageal submueosal cancer by endoscopic classification was 89.7%(70/78).Conclusion This endoscopic classification system is effective in differentiating esophageal mucosal cancer from submucosal ones.

Malignant Mixed Mullerian Tumor of the Uterus: Retrospective Study of 26 cases / 대한산부인과학회지

OBJECTIVE: To review the clinicopathological characteristics and prognosis of patients with malignant mixed Mullerian tumor (MMMT) of the uterus. METHODS: Retrospective clinical study was done on 26 patients diagnosed with the MMMT of the uterus at our hospital from Janurary, 1994 to December, 2004. Demographic data, pathologic findings, stages, treatment, prognosis and survival time were reviewed. RESULTS: The median age of patients was 59 years. Most of the patients (76.9%) were in the postmenopausal state. The most common symptom was vaginal bleeding (65.4%). There were 17 patients (65.4%) with stage I, 3 patients (11.6%) with stage II, 4 patients (15.4%) with stage III, 2 patients (7.6%) with stage IV disease in this study. Of the hysterectomy specimens, 4 (15.4%) of them were heterologous tumors, 22 (84.6%) of them were homologous tumors. Overall 5 year survival rate of all stages was 60% and the patients with advanced stages (III, IV) showed poorer prognosis than the patients with early stages (I, II) (P=0.001). Myometrial invasion depth was also significant prognostic factor (P<0.001). CONCLUSION: The MMMT of the uterus is a highly malignant tumor and the significant prognostic factor is the FIGO stage and myometrial invasion depth.

Clinicopathological Study on Laterally Spreading Tumor (LST) / 대한소화기내시경학회지

BACKGROUND/AIMS: Laterally spreading tumors (LST) were growthed along the colonic wall. These tumors were high malignant potential compared to colon polyp. We analyzed clinicopathological characteristics of these tumors. METHODS: From June 1996 to June 2001, twenty nine patients were diagnosed by colonoscopy. These lesions were classificated macroscopic (granular type and nongranular type) and microscopic findings. RESULTS: 20 male and 9 female were enrolled (mean age, 68.1). Among the LST, 41.4% were 20~30 mm in diameter, and 7% were larger than 30 mm. According to macroscopic findings granular types were 72.4% (21/29) and nongranular types were 27.6% (8/29). In macroscopic findings, tubular types were 48.4% (14/29), malignant changes were 31.3% (9/29). Tumor size was only significant factor in malignant potential of LST (p=0.004). Endoscopic mucosal resection was performed in 72.4% (21/29), operation in 8 (27.6%). Rate of submucosal invasion in LST was 3.4% (1/29, sm1). Recurrent rate of endoscopic treatment group was 9.5% (2/21). CONCLUSIONS: Most of LST were good indication for endoscopic treatment, but larger tumor size and irregular surface of tumor were suspected to be submucosal invasion. Therefore these lesions were performed other procedures as endoscopic ultrasound or computerized tomography for invasion depth.