Endosc Int Open 2017; 05(09): E825-E833
DOI: 10.1055/s-0043-113632
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of image-enhanced endoscopic technology using advanced diagnostic endoscopy for the detection of early gastric cancer: a pilot study

Daisuke Yamaguchi1, Shinya Kodashima2, Mitsuhiro Fujishiro1, 2, Satoshi Ono2, Keiko Niimi2, 3, Satoshi Mochizuki2, Yosuke Tsuji2, Itsuko Asada-Hirayama2, Yoshiki Sakaguchi2, Satoki Shichijo2, Chihiro Minatsuki2, Nobutake Yamamichi2, Kazuhiko Koike2
  • 1Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  • 2Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  • 3Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Further Information

Publication History

submitted 25 July 2016

accepted after revision 24 May 2017

Publication Date:
12 September 2017 (online)

Abstract

Background and study aims Image-enhanced endoscopy (IEE) plays an important role in early detection and detailed examination of early gastric cancer (EGC). The current study aimed to clarify the efficacy of IEE using advanced diagnostic endoscopy for EGC detection without magnification.

Patients and methods We performed endoscopic examinations without magnification in patients referred to our hospital with a diagnosis of upper gastrointestinal tumor detected through routine screening endoscopy. In this study, we used three IEE technologies: narrow-band imaging; blue laser imaging; and i-scan optical enhancement. The detection rates for EGC between IEE and white-light imaging (WLI) were compared.

Results Between July 2013 and June 2014, 156 patients were enrolled. Among upper gastrointestinal tumors, we analyzed endoscopic examination results of 119 lesions that were histologically diagnosed as EGC in 109 patients. The EGC detection rate in the IEE plus WLI groups was 77.3 %. Although the EGC detection rate in the IEE group was higher than that in the WLI group (80.0 % vs. 70.3 %), there was no significant difference between these two modalities. An important detection factor using IEE was tumor circumference, where the rate of detection in the anterior wall and lesser curvature was significantly higher than that in the posterior wall and greater curvature (P = 0.046). An important detection factor using WLI was color variation, where the rate of occurrence of a reddened or pale tumor was significantly higher than that of normal colored tumors (P = 0.030).

Conclusions The detection rate of EGC without magnification was similar between the IEE group and the WLI group. Important detection factors differed between IEE and WLI; therefore, the IEE and WLI modalities have different characteristics regarding EGC detection. Consequently, we propose to use both IEE and WLI in the evaluation of EGC.