Clinical and Endoscopic Characterization of Depressed Gastric Adenoma

Tamai, Naoto; Kaise, Mituru; Nakayoshi, Takaharu; Katoh, Masasi; Sumiyama, Kazuki; Gohda, K.; Yamasaki, T.; Arakawa, Hiromichi; Tajiri, Hisao

doi:10.1055/s-2005-921207

Cited by 41 publications

(45 citation statements)

References 7 publications

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“…ME-NBI enables us to clearly visualize the MV and MS architecture [13]. Tamai et al [17] reported that depressed adenomas showed a regular ultrafine network pattern of mucosal microvasculature in ME-NBI, but none of the protruding adenomas possessed these MV patterns. Yao et al also reported some difficulties in discriminating carcinomas from adenomas only by visualizing MV patterns, due to the obscurity of MV patterns in superficial elevated (0-IIa) lesions.…”

Section: Discussionmentioning

confidence: 99%

“…In non-magnifying endoscopy, lesion size, color (red or white), macroscopic type of the lesion (depressed or others), and the presence of ulceration were examined, based on the past reports about the association between endoscopic findings and histological malignancy [6,17,20,21]. Lesion size was determined using a measuring forceps.…”

Section: Endoscopic Procedures and Diagnosismentioning

confidence: 99%

“…More accurate discrimination between adenomas and cancerous lesions can minimize the chances that the latter will be misdiagnosed as the former, thus minimizing the chances that the latter will go untreated. Some studies have tried to differentiate between these lesions with ME-NBI, but the findings are not sufficient to propose a new criterion [9,16,17]. In the present study, we examined the feasibility of using ME-NBI to discriminate early gastric cancers (Vienna classification category 4 or 5) from adenomas in lesions diagnosed as adenomas (Vienna classification category 3) by pre-treatment biopsy.…”

Section: Introductionmentioning

confidence: 97%

“…Recent improvements in the technique of magnifying endoscopy with narrow-band imaging (ME-NBI) have increased the accuracy of discrimination between cancers and non-cancerous lesions [9][10][11][12][13][14][15][16][17][18]. If clinicians can more accurately detect gastric cancers by ME-NBI, it will help to determine the management of the lesions with a noncommittal strategy, endoscopic treatment or follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

et al. 2012

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Background There are no clear clinical criteria for the management of gastric lesions diagnosed as adenomas (Vienna classification category 3) by pre-treatment biopsy. In the present study, we examined the feasibility of magnifying endoscopy with narrow-band imaging (ME-NBI) in discriminating early gastric cancers (Vienna classification category 4 or 5) from adenomas in lesions diagnosed as adenomas by pre-treatment biopsy. Methods This was a single-center cross-sectional retrospective study at a tertiary referral center. One hundred thirty-seven consecutive cases of gastric lesions diagnosed as adenomas in pre-treatment forceps biopsy were examined with conventional non-magnifying endoscopy under white light, non-magnifying chromoendoscopy, and ME-NBI. We investigated the association between the final pathological diagnoses (carcinoma or adenoma) and the following factors: lesion size (mm), color (red or white), macroscopic type (depressed or others), presence of ulceration, and positive ME-NBI finding. The presence of an irregular microvascular pattern or an irregular microsurface pattern with a demarcation line between the lesion and the surrounding area was regarded as a positive ME-NBI finding. Results Lesion size was significantly larger in carcinomas than adenomas (P = 0.005). Depressed lesion (P = 0.011), red color (P \ 0.001), and positive ME-NBI finding (P \ 0.001) were significant predictive factors for carcinoma. Multivariate logistic regression confirmed that red color (odds ratio [OR] 3.04, 95% confidence interval [CI] 1.26-7.34, P = 0.14) and a positive ME-NBI finding (OR 13.68,, P \ 0.001) were independent predictive factors for carcinomas. A positive ME-NBI finding was the strongest predictive factor. Conclusions ME-NBI is useful in planning the management of lesions diagnosed as adenomas by pre-treatment forceps biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Endoscopic Procedures and Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

et al. 2012

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“…ME with a narrow band image can aid in deciding the target of endoscopic biopsy for surveillance in Barrett's esophagus [5][6][7][8] . The relationships between ME findings and gastric neoplastic histology, including the types of cancer detected, are now being investigated, and the usefulness of ME for diagnosing early gastric cancer has been reported [9][10][11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

Lee¹,

Chung²,

Park³

et al. 2009

WJG

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AIM:To investigate the relationship between postendoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME. From January, 2007 to June, 2008 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies. METHODS: RESULTS:CE findings showed nodular scars (53/129), erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (Ⅰ) 47 round; (Ⅱ) 54 short rod or tubular; (Ⅲ) 19 branched or gyrus-like; and (Ⅳ) 9 destroyed pits. Sensitivity and specificity were 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type Ⅳ pit patterns were diagnosed as tumor lesions, and 120 cases of type Ⅰ-Ⅲ pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%. CONCLUSION: ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.

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Polypöse Magentumoren

Stolte¹

2013

Pathologie

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Clinical and Endoscopic Characterization of Depressed Gastric Adenoma

Cited by 41 publications

References 7 publications

Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

Polypöse Magentumoren

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