Flexible magnifying endoscopy with narrow band imaging for the diagnosis of uterine cervical tumors: A cooperative study among gastrointestinal endoscopists and gynecologists to explore a novel microvascular classification system

Abstract

Abstract. Narrow band imaging with magnifying endoscopy (NBI-ME), which is useful for the assessment of micro-vessels, has excellent diagnostic potential for early gastrointestinal epithelial neoplasia. Conventional diagnostic tools for uterine cervical epithelial tumors are still unsatisfactory. An accurate diagnostic tool for uterine cervical epithelial tumors is required to preserve the reproductive ability of young women with uterine cervical tumors. Flexible NBI-ME was performed in patients with cervical squamous cell lesions that required further examinations based on their Pap smear results (cytology ≥ low-grade squamous intraepithelial lesion) at Kagawa University Hospital between April 2014 and April 2015. NBI-ME results concordant with the punch biopsy sites were compared with the histological results. A retrospective review of the NBI-ME images identified abnormal NBI-ME results regarding micro-vascular patterns. All images were categorized as having abnormal features. NBI-ME revealed the following vascular pattern differences of different stage tumors: Dot-like vessels without irregular arrangements and high density in cervical intraepithelial neoplasia (CIN) CIN1-CIN2; dot-like vessels with irregular arrangements and high density in CIN3-carcinoma in situ; crawling vessels in minimum invasive cancer; and willow branch vessels and new tumor vessels in invasive cancer. NBI-ME may be an effective diagnostic tool for uterine cervical epithelial tumors, which may lead to the establishment of a novel classification system.

In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy -a prospective pilot study-

“…Endocytoscopy might be useful for determination of the need for conization. Recently, there have been a few reports on the usefulness of flexible magnifying endoscopy with narrow band imaging (ME-NBI) for evaluation of CIN [15,16]. ME-NBI visualizes microstructures of the mucosa showing microvascular features with 80-100-fold.…”

In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy - a prospective pilot study-

“…Recently, there have been a few reports on the usefulness of exible magnifying endoscopy with narrow band imaging (ME-NBI) for evaluation of CIN [15,16]. ME-NBI visualizes microstructures of the mucosa showing microvascular features with 80-100-fold.…”

Quality Assessment of Endoscopic Forceps Biopsy Samples under Magnifying Narrow Band Imaging for Histological Diagnosis of Cervical Intraepithelial Neoplasia: A Feasibility Study

“…In areas suspicious for ≥CIN2, magnifying observation was performed as necessary ( Figure 3 b). The diagnostic criteria for the ≥CIN2 lesions were based on our previous studies as follows: the presence of thick white epithelium or thin white epithelium plus atypical vessels or dense acetowhite epithelium (W2) [ 5 , 6 ]. White epithelium was defined as thin white epithelium when the underlying vessels were visible, and thick white epithelium when the underlying vessels were invisible.…”

“…Moreover, in combination with magnifying endoscopy (ME), it visualizes microvascular architecture and microsurface structure that correspond with histology. We have developed a novel method that uses flexible gastrointestinal ME-NBI for the diagnosis of CIN [ 5 ]. We found that the ME-NBI showed the characteristic findings of CIN better than colposcopy [ 6 ].…”