Current Clinical Applications of Magnifying Endoscopy with Narrow Band Imaging in the Stomach

Li, Haiyan; Ge, Zhi‐Zheng; Fujishiro, Mitsuhiro; Li, Xiaobo

doi:10.1155/2012/271914

Cited by 15 publications

(10 citation statements)

References 43 publications

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“…22 However, the margins remain difficult to be predicted using NBI for undifferentiated carcinoma, since the tumor often grows horizontally, diffusely or thinly within the lamina propria before exposing on the mucosal surface. 27 On the contrary, a recent prospective study recommended the use of NBI in the diagnostic demarcation of undifferentiated EGC for its diagnostic accuracy reached 81.6%, which is higher than that of WLE (54.0%). 28 These conflicting results may be due to the diameter of the tumor, the profi-ciency of the endoscopist and different criteria used to define accuracy.…”

Section: Tumor Marginmentioning

confidence: 91%

“…In addition to the superior diagnostic rate reported in several studies, NBI can still help to achieve a better delineation of tumors with unclear margins in approximately 20% of the EGC by using both WLE and CE, and the combined use of NBI and CE makes the demarcation of the tumor easier . However, the margins remain difficult to be predicted using NBI for undifferentiated carcinoma, since the tumor often grows horizontally, diffusely or thinly within the lamina propria before exposing on the mucosal surface . On the contrary, a recent prospective study recommended the use of NBI in the diagnostic demarcation of undifferentiated EGC for its diagnostic accuracy reached 81.6%, which is higher than that of WLE (54.0%) .…”

Section: Tumor Marginmentioning

confidence: 99%

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Endoscopic prediction of tumor margin and invasive depth in early gastric cancer

Zhou

2015

J of Digest Diseases

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Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related deaths in the world. The prognosis of GC is clearly associated with the tumor stage, with a 5-year overall survival rate for early gastric cancer (EGC) exceeding 90%, which is significantly higher than that of advanced gastric cancer. Endoscopic resection, including endoscopic mucosal resection and endoscopic submucosal dissection, has been adopted in recent decades as the first treatment option of EGC in many countries for its minimal invasion and high curative rate. However, the horizontal and vertical margins are related to the curative resection of EGC and the prognosis of patients. Thus the accurate prediction of the tumor boundary and its invasive depth before treatment counts for much in planning the most appropriate treatment strategy and promising curative resection. To date, various endoscopic techniques have been identified to play a role in pretreatment evaluation, such as white light endoscopy, chromoendoscopy, narrow band imaging and endoscopic ultrasonography. This article aimed to summarize the diagnostic methods, applications and limitations of these different endoscopic techniques for identifying tumor horizontal and vertical margins in EGC, helping to increase preoperative evaluation of capabilities and to improve the curative resection rate of EGC.

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Section: Tumor Marginmentioning

confidence: 91%

Section: Tumor Marginmentioning

confidence: 99%

Endoscopic prediction of tumor margin and invasive depth in early gastric cancer

Zhou

2015

J of Digest Diseases

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“…Clinically, the combination of magnifying endoscopy with narrow band imaging (commonly known as ME-NBI) may be used to detect antralization, although its performance needs to be further validated. Li et al 67 reported that under ME-NBI, the body-type mucosa presents as a honeycomb-like subepithelial capillary network (dark brown), with an oval dark glandular opening in the center and interspersed with spider-like collecting veins (Fig. 3a), whereas the antral-type mucosa presents as a curly or wavy subepithelial capillary network, with the spider-like collecting veins being rarely observed (Fig.…”

Section: Diagnosis Of Antralization and Its Implications In Clinical mentioning

confidence: 99%

Role of Helicobacter pylori-induced Antralization in Gastric Carcinogenesis and its Implications in Clinical Practice

Ye¹,

Zhang²,

He³

et al. 2019

Exploratory Research and Hypothesis in Medicine

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The aim of this article was to review the roles of Helicobacter pylori-induced antralization in gastric carcinogenesis and its implications in clinical practice. A search of PubMed/PubMed Central, Web of Science, and China National Knowledge Infrastructure was performed in December 2018 to retrieve all literature related to antralization (or antralisation), pyloric (or pseudopyloric) glands, pyloric (or pseudopyloric) metaplasia, or pyloric (or pseudopyloric) gland metaplasia, and spasmolytic polypeptide-expressing metaplasia (or SPEM). Among the synonyms, antralization and SPEM, which are derived in the same mechanisms at the molecular, cellular and tissue levels, are more commonly used in recent studies. Antralization (or SPEM) is associated with H. pylori infection, atrophic gastritis and intestinal metaplasia, while H. pylori eradication may reverse antralization. It is proposed that H. pylori infection leads to inflammation in the gastric mucosa and apoptosis of the epithelial cells of the proximal stomach, including gastric incisura, body and fundus. The stem cells proliferate and transform into mucous cells and form antral-type mucosa (i.e. antralization). Subsequently, H. pylori-induced antralization, if not controlled, may develop into atrophic gastritis, intestinal metaplasia, dysplasia, and early intestinal-type gastric cancer. Although many biomarkers, including the spasmolytic polypeptide and mucin 6, are specifically expressed in the gastric mucosa with antralization, none of them are evaluated for the clinical diagnosis of antralization. H. pyloriinduced antralization (or SPEM) is believed to be an initiating and reversible stage of gastric carcinogenesis. Identification of antralization would help make an early intervention to cease or even reverse the process toward the development of gastric cancer. Currently, the "gold standard" for diagnosing antralization is pathology, which is invasive and time consuming. A non-invasive and convenient method that accurately and specifically diagnoses antralization is urgently required.

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“…Furthermore, few studies evaluating the usefulness of predicting invasion depth have been performed in cases of differentiated cancer. This is probably because undifferentiated cancer often spreads within the lamina propria sparsely before its exposure on the mucosal surface [38]. Another reason is that even patients with small undifferentiated cancers are more likely to undergo surgery than ESD.…”

Section: Limitations Of Nbimentioning

confidence: 99%

Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach

Kim

2018

Clin Endosc

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There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopy with narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations with invasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imaging offers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitations of narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness in undifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use of endoscopic submucosal dissection for the treatment of gastric tumors.

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Current Clinical Applications of Magnifying Endoscopy with Narrow Band Imaging in the Stomach

Cited by 15 publications

References 43 publications

Endoscopic prediction of tumor margin and invasive depth in early gastric cancer

Endoscopic prediction of tumor margin and invasive depth in early gastric cancer

Role of Helicobacter pylori-induced Antralization in Gastric Carcinogenesis and its Implications in Clinical Practice

Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach

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