Endocytoscopy is a promising modality with high diagnostic accuracy for gastric cancer

Mitsuru Kaise; Yasuo Ohkura; Toshiro Iizuka; Ryusuke Kimura; Kosuke Nomura; Yasutaka Kuribayashi; Akihiro Yamada; Satoshi Yamashita; Tsukasa Furuhata; Daisuke Kikuchi; Osamu Ogawa; Akira Matsui; Toshifumi Mitani; Shu Hoteya

doi:10.1055/s-0034-1377965

Endoscopy, Table of Contents

Endoscopy 2015; 47(01): 19-25
DOI: 10.1055/s-0034-1377965

Original article

Endocytoscopy is a promising modality with high diagnostic accuracy for gastric cancer

Mitsuru Kaise

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Yasuo Ohkura

²Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan

,

Toshiro Iizuka

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Ryusuke Kimura

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Kosuke Nomura

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Yasutaka Kuribayashi

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Akihiro Yamada

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Satoshi Yamashita

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Tsukasa Furuhata

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Daisuke Kikuchi

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Osamu Ogawa

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Akira Matsui

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Toshifumi Mitani

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

,

Shu Hoteya

¹Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

› Author Affiliations

Abstract

Background and study aim: Endocytoscopy (ECS) enables in vivo microscopic imaging, which allows analysis of mucosal structures at the cellular level; however, limited data are available on the validity of ECS in the stomach. The aim of this study was to evaluate the feasibility of ECS in the diagnosis of early gastric cancer.

Patients and methods: Gastric lesions that were the targets of histopathological diagnosis by endoscopic submucosal dissection or biopsy specimen were prospectively enrolled and evaluated using a single charge-coupled device-integrated endocytoscope, following double staining with crystal violet and methylene blue. High grade ECS atypia was defined according to specific irregularities in gland structure and cell nuclei. The primary end point was the accuracy of ECS diagnosis for gastric cancer, using histopathological diagnosis as the gold standard.

Results: A total of 82 lesions were investigated, including 23 early gastric cancers, 10 gastric adenomas, and 49 non-neoplastic lesions. Ten lesions could not be clearly observed by ECS because of poor staining due to viscous mucus or plaque; thus, assessability rates with ECS were 88 % in total and 91 % for gastric cancer. High grade ECS atypia was observed in 86 % of assessable gastric cancers, but not in any cases of gastric adenomas or non-neoplastic lesions. The sensitivity, specificity, positive and negative predictive values of high grade ECS atypia as the criterion for the diagnosis of gastric cancer were 86 %, 100 %, 100 %, and 94 %, respectively. No serious complications occurred during or after the examinations.

Conclusion: ECS is a clinically feasible modality to obtain in vivo histology, with high diagnostic accuracy in gastric cancer.

Full Text

References

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