Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging

Hiroki Nakamura; Shin-ei Kudo; Masashi Misawa; Shinichi Kataoka; Kunihiko Wakamura; Takemasa Hayashi; Toyoki Kudo; Yuichi Mori; Kenichi Takeda; Katsuro Ichimasa; Hideyuki Miyachi; Atushi Katagiri; Fumio Ishida; Haruhiro Inoue

doi:10.1055/s-0042-117629

Endoscopy International Open, Inhaltsverzeichnis

Endoscopy 2016; 04(12): E1280-E1285
DOI: 10.1055/s-0042-117629

Original article

Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging

Hiroki Nakamura

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Shin-ei Kudo

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Masashi Misawa

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Shinichi Kataoka

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Kunihiko Wakamura

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Takemasa Hayashi

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Toyoki Kudo

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Yuichi Mori

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Kenichi Takeda

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Katsuro Ichimasa

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Hideyuki Miyachi

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Atushi Katagiri

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Fumio Ishida

¹Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

,

Haruhiro Inoue

²Digestive Disease Center, Showa University, Koto-Toyosu Hospital, Tokyo, Japan

› Institutsangaben

Abstract

Background and study aims: Magnifying narrow-band imaging (NBI) is useful for examination of colorectal lesions, and endocytoscopy (EC) allows diagnostic evaluation of structural atypia, nuclear atypia, and vascular structures of colorectal tumors. The aim of this study was to examine surface microvessels in deep invasive colorectal cancer using EC with a new NBI video processor system.

Patients and methods: We retrospectively assessed 132 colorectal neoplastic lesions: 81 adenomas, 18 intramucosal cancers, 4 submucosal slightly invasive cancers, and 29 submucosal deep invasive cancers. Detailed vascular findings commonly seen in submucosal deep invasive carcinomas included > 2-fold vasodilatation seen in adenomas, abnormal tortuosity and branching, loss of the micro-network pattern, caliber change in > 2 places in a single blood vessel, and blood vessels not visible in a line because they appear like a string of beads (beaded sign).

Results: Univariate analysis revealed 4 vascular findings that were strongly predictive of submucosal deep invasion: vasodilatation (odds ratio [OR] 9.31; 95 % confidence interval [CI] 3.57 – 24.30), loss of the micro-network pattern (OR 61.60; 95 % CI 17.87 – 212.29), caliber change (OR 35.7; 95 % CI 9.16 – 139.14), and the beaded sign (OR 45.90; 95 % CI 5.50 – 382.73).

Conclusions: Detailed assessment of ultra-magnified microvessels could improve the diagnostic performance for submucosal deep invasive cancer.

Study registration: UMIN-CTR000014033

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Referenzen

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