1
|
Chen T, Lin R, Wang W, Lee C, Tseng C, Hsu W, Tai W, Wang H, Chang C. Validation of simplified classification of magnifying endoscopy for diagnosis of Barrett's dysplasia with blue laser imaging. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tzu‐Haw Chen
- Department of Internal Medicine E‐Da Hospital/I‐Shou University Kaohsiung Taiwan
| | - Ro‐Ting Lin
- Department of Occupational Safety and Health China Medical University Taichung Taiwan
| | - Wen‐Lun Wang
- Department of Internal Medicine E‐Da Hospital/I‐Shou University Kaohsiung Taiwan
| | - Ching‐Tai Lee
- Department of Internal Medicine E‐Da Hospital/I‐Shou University Kaohsiung Taiwan
| | - Cheng‐Hao Tseng
- Department of Internal Medicine E‐Da Hospital/I‐Shou University Kaohsiung Taiwan
| | - Wen‐Hung Hsu
- Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan
| | - Wei‐Chen Tai
- Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan
| | - Hsiu‐Po Wang
- Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
| | - Chi‐Yang Chang
- Department of Internal Medicine E‐Da Hospital/I‐Shou University Kaohsiung Taiwan
- School of Medicine Fu Jen Catholic University New Taipei Taiwan
| |
Collapse
|
2
|
Junquera F, Fernández-Ananín S, Balagué C. Therapeutic options for early cancer of the esophagogastric junction. Cir Esp 2019; 97:438-444. [PMID: 31138450 DOI: 10.1016/j.ciresp.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/03/2019] [Indexed: 02/07/2023]
Abstract
Early-stage (T1) esophagogastric junction cancer continues to represent 2-3% of all cases. Adenocarcinoma is the most frequent and important type, the main risk factors for which are gastroesophageal reflux and Barrett's esophagus with dysplasia. Patients with mucosal (T1a) or submucosal (T1b) involvement initially require a thorough digestive endoscopy, and narrow-band imaging can improve visualization. Endoscopic treatment of these lesions includes endoscopic mucosal resection, radiofrequency ablation and endoscopic submucosal dissection. Accurate staging is necessary in order to provide optimal treatment. The most precise staging technique in these cases is endoscopic ultrasound. The suspicion of deep invasion of the submucosa, presence of unfavorable anatomopathological characteristics or impossibility to perform endoscopic resection make it necessary to consider surgical resection.
Collapse
Affiliation(s)
- Félix Junquera
- Departamento de Endoscopia Digestiva, Consorci Hospitalari Parc Taulí, Sabadell, España
| | - Sonia Fernández-Ananín
- Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, España
| | - Carmen Balagué
- Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, España.
| |
Collapse
|
3
|
Osawa H, Miura Y, Takezawa T, Ino Y, Khurelbaatar T, Sagara Y, Lefor AK, Yamamoto H. Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening. Clin Endosc 2018; 51:513-526. [PMID: 30384402 PMCID: PMC6283759 DOI: 10.5946/ce.2018.132] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/15/2018] [Accepted: 09/18/2018] [Indexed: 12/16/2022] Open
Abstract
White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication. LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.
Collapse
Affiliation(s)
- Hiroyuki Osawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yoshimasa Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Takahito Takezawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yuji Ino
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Tsevelnorov Khurelbaatar
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Yuichi Sagara
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Alan Kawarai Lefor
- Department of Medicine, Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| |
Collapse
|
4
|
Braden B, Jones-Morris E. How to get the most out of costly Barrett's oesophagus surveillance. Dig Liver Dis 2018; 50:871-877. [PMID: 29730158 DOI: 10.1016/j.dld.2018.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 12/11/2022]
Abstract
Current endoscopic surveillance protocols for Barrett's oesophagus have several limitations, mainly the poor cost-effectiveness and high miss rate. However, there is sufficient evidence that patients enrolled in a surveillance program have better survival chances of oesophageal cancer due to earlier tumor stages at diagnosis compared to patients with de novo diagnosed oesophagus cancer. Risk stratifications aim to identify patients at highest risk of developing adenocarcinoma of the oesophagus; most of them base on the length of the Barrett's segment and the presence of dysplasia. This review discusses prognostic factors and provides practical guidance on how to improve the efficacy and outcome in Barrett's surveillance programs.
Collapse
Affiliation(s)
- Barbara Braden
- Translation Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Evonne Jones-Morris
- Translation Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
5
|
Takahashi H, Miura Y, Osawa H, Takezawa T, Ino Y, Okada M, Lefor AK, Yamamoto H. Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer. Clin Endosc 2018; 52:273-277. [PMID: 30103296 PMCID: PMC6547336 DOI: 10.5946/ce.2018.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/04/2018] [Indexed: 01/26/2023] Open
Abstract
Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.
Collapse
Affiliation(s)
- Haruo Takahashi
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Yoshimasa Miura
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Hiroyuki Osawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takahito Takezawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Yuji Ino
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Masahiro Okada
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| |
Collapse
|
6
|
Liu JH, Liu DY, Wang L, Han LP, Qi ZY, Ren HJ, Feng Y, Luan FM, Mi LT, Shan SM. Animal experimental studies using small intestine endoscope. World J Gastroenterol 2017; 23:3684-3689. [PMID: 28611521 PMCID: PMC5449425 DOI: 10.3748/wjg.v23.i20.3684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/28/2017] [Accepted: 03/21/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the feasibility and safety of a novel enteroscope, negative-pressure suction endoscope in examining the small intestine of a porcine model.
METHODS In vitro experiments in small intestinal loops from 20 pigs and in vivo experiments in 20 living pigs were conducted.
RESULTS In in vitro experiments, a negative pressure of > 0.06 MPa was necessary for optimal visualization of the intestine, and this pressure did not cause gross or histological damage to the mucosa. For satisfactory examination of the small intestine in vivo, higher negative pressure (> 1.00 MPa) was required. Despite this higher pressure, the small intestine did not show any gross or microscopic damage in the suctioned areas. The average time of examination in the living animals was 60 ± 7.67 min. The animals did not experience any apparent ill effects from the procedure.
CONCLUSION Small intestine endoscope was safely performed within a reasonable time period and enabled complete visualization of the intestine in most cases.
Collapse
|
7
|
Kato M, Goda K, Shimizu Y, Dobashi A, Takahashi M, Ikegami M, Shimoda T, Kato M, Sharma P. Image assessment of Barrett's esophagus using the simplified narrow band imaging classification. J Gastroenterol 2017; 52:466-475. [PMID: 27448208 DOI: 10.1007/s00535-016-1239-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/29/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND A simplified narrow band imaging (NBI) classification has been proposed with the objective of integrating multiple classifications of NBI surface patterns in Barrett's esophagus (BE). Little is known about the impact of the simplified NBI classification on the diagnosis of BE when using high-definition magnification endoscopy with NBI (HM-NBI). This study aimed to evaluate (a) the reproducibility of NBI surface patterns and predicted histology and (b) the diagnostic accuracy of interpreting HM-NBI images by using the simplified NBI classification. METHODS Two hundred and forty-eight HM-NBI images from macroscopically normal areas in patients with BE were retrieved from endoscopy databases and randomized for review by four endoscopists (two experts, two non-experts). We evaluated inter- and intra-observer agreement of the interpretation of NBI surface patterns and the predicted histology (dysplasia vs. non-dysplasia), as calculated by using κ statistics, and diagnostic values of the prediction. RESULTS The overall inter-observer agreements were substantial for mucosal pattern (κ = 0.73) and vascular pattern (κ = 0.71), and almost perfect for predicting dysplastic histology (κ = 0.80). The overall intra-observer agreements were almost perfect for mucosal (κ = 0.84) and vascular patterns (κ = 0.86), and predicting dysplastic histology (κ = 0.89). The mean accuracy in predicting dysplastic histology for all reviewers was 95 % (experts: 96.8 %, non-experts: 93.1 %). CONCLUSIONS The simplified NBI classification has the potential to provide high diagnostic reproducibility and accuracy when using HM-NBI.
Collapse
Affiliation(s)
- Masayuki Kato
- Department of Endoscopy, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Kenichi Goda
- Department of Endoscopy, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Yuichi Shimizu
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Dobashi
- Department of Endoscopy, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masakazu Takahashi
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Masahiro Ikegami
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Mototsugu Kato
- National Hospital Organization Hakodate Hospital, Hakodate, Japan
| | - Prateek Sharma
- Division of Gastroenterology, Hepatology and Motility, University of Kansas Medical Center, Kansas, USA
| |
Collapse
|