Prediction of submucosal gastric cancer by narrow-band imaging magnifying endoscopy

Yagi, Kazuichi; Saka, Akiko; Nozawa, Yoshinori; Nakamura, Atsuo; Umezu, Hajime

doi:10.1016/j.dld.2013.09.003

Cited by 11 publications

(4 citation statements)

References 11 publications

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“…CE has also the potential for predicting EGC differentiation [26,27]. Several studies also suggest that CE can be used for prediction of depth of invasion, with a blurry mucosal and irregular mesh pattern suggesting submucosal invasion, with a global accuracy superior to 80 % [27][28][29][30]. However, no validated classification exists nor is there any study suggesting that CE is better than standard high resolution WLE for this purpose, and the decision not to endoscopically resect the lesion is still based mainly on macroscopic features of the lesion (▶ Fig.…”

Section: Stomach Lesionsmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Pimentel‐Nunes

Libânio

Bastiaansen³

et al. 2022

Endoscopy

347

212

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Main recommendationsESGE recommends that the evaluation of superficial gastrointestinal (GI) lesions should be made by an experienced endoscopist, using high definition white-light and chromoendoscopy (virtual or dye-based).ESGE does not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT prior to endoscopic resection.ESGE recommends endoscopic submucosal dissection (ESD) as the treatment of choice for most superficial esophageal squamous cell and superficial gastric lesions.For Barrett’s esophagus (BE)-associated lesions, ESGE suggests the use of ESD for lesions suspicious of submucosal invasion (Paris type 0-Is, 0-IIc), for malignant lesions > 20 mm, and for lesions in scarred/fibrotic areas.ESGE does not recommend routine use of ESD for duodenal or small-bowel lesions.ESGE suggests that ESD should be considered for en bloc resection of colorectal (but particularly rectal) lesions with suspicion of limited submucosal invasion (demarcated depressed area with irregular surface pattern or a large protruding or bulky component, particularly if the lesions are larger than 20 mm) or for lesions that otherwise cannot be completely removed by snare-based techniques.ESGE recommends that an en bloc R0 resection of a superficial GI lesion with histology no more advanced than intramucosal cancer (no more than m2 in esophageal squamous cell carcinoma), well to moderately differentiated, with no lymphovascular invasion or ulceration, should be considered a very low risk (curative) resection, and no further staging procedure or treatment is generally recommended.ESGE recommends that the following should be considered to be a low risk (curative) resection and no further treatment is generally recommended: an en bloc R0 resection of a superficial GI lesion with superficial submucosal invasion (sm1), that is well to moderately differentiated, with no lymphovascular invasion, of size ≤ 20 mm for an esophageal squamous cell carcinoma or ≤ 30 mm for a stomach lesion or of any size for a BE-related or colorectal lesion, and with no lymphovascular invasion, and no budding grade 2 or 3 for colorectal lesions.ESGE recommends that, after an endoscopically complete resection, if there is a positive horizontal margin or if resection is piecemeal, but there is no submucosal invasion and no other high risk criteria are met, this should be considered a local-risk resection and endoscopic surveillance or re-treatment is recommended rather than surgery or other additional treatment.ESGE recommends that when there is a diagnosis of lymphovascular invasion, or deeper infiltration than sm1, or positive vertical margins, or undifferentiated tumor, or, for colorectal lesions, budding grade 2 or 3, this should be considered a high risk (noncurative) resection, and complete staging and strong consideration for additional treatments should be considered on an individual basis in a multidisciplinary discussion.ESGE recommends scheduled endoscopic surveillance with high definition white-light and chromoendoscopy (virtual or dye-based) with biopsies of only the suspicious areas after a curative ESD.

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Section: Stomach Lesionsmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Pimentel‐Nunes

Libânio

Bastiaansen³

et al. 2022

Endoscopy

347

212

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“…Thus, 15 potentially eligible studies were subsequently appraised. After retrieval of full text, we excluded studies which did not use VS classification system, [ 11 – 13 ] did not present sufficient data to permit calculation of sensitivity and specificity, [ 14 , 15 ] or presented data that was reported elsewhere. [ 16 ] At last, 9 studies met the inclusion criteria and were included.…”

Section: Resultsmentioning

confidence: 99%

The accuracy of magnifying narrow band imaging (ME-NBI) in distinguishing between cancerous and noncancerous gastric lesions

Zhou

Wu²,

Huang³

et al. 2018

Medicine

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Background:Previous clinical trials have demonstrated the diagnostic accuracy of magnifying narrow-band (ME-NBI) for gastric cancerous lesions, but the results are inconsistent. The purpose of this meta-analysis is to investigate the accuracy of ME-NBI in distinguishing between cancerous and noncancerous gastric lesions.Methods:Systematic literature searches were conducted until October 2016 in PubMed, Embase by 2 independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity. Two authors independently evaluated studies for inclusion, rated methodological quality, and abstracted relevant data. Meta-analytic method was used to construct summary receiver operating characteristic curves, and pooled sensitivity, specificity were calculated.Results:Nine studies enrolling 5398 lesions were included. The pooled sensitivity, specificity were 88% (95% confidence interval [CI]: 78–93%), 96% (95% CI: 91–98%), respectively. The area under the curve (AUC) was 0.97. There was a large heterogeneity between the included studies. Studies with lesions ≤ 10 mm still had a high pooled sensitivity of 81% (95% CI: 73–90%) and specificity of 97% (95% CI: 95–100%). Studies which analyzed resected specimens had a sensitivity of 91% (95 CI: 82–99%) and specificity of 88% (95% CI: 83–94%), and studies which analyzed biopsied specimens had a sensitivity of 85% (95 CI: 74–96%) and specificity of 99% (95% CI: 98–99%).Conclusions:ME-NBI is highly accurate and consistent to distinguish between gastric cancerous and noncancerous lesions.

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“…Yagi et al described a blurry mucosal pattern and an irregular mesh pattern as independent predictors of submucosal invasion. 82 Other investigators have reported on non-structure scattery vessels, multi-caliber vessels and dilated vessels associated with submucosal invasion. 83,84 Dye-based chromoendoscopy with indigo-carmine can be used to delineate the margins of a gastric lesion for attempt at curative resection.…”

Section: Early Gastric Carcinomamentioning

confidence: 97%

Narrowed-spectrum Technologies in Endoscopic Imaging of The Upper Gastrointestinal Tract

Kamboj

Kahn

Leggett

2021

Techniques and Innovations in Gastrointestinal Endoscopy

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Prediction of submucosal gastric cancer by narrow-band imaging magnifying endoscopy

Cited by 11 publications

References 11 publications

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022

The accuracy of magnifying narrow band imaging (ME-NBI) in distinguishing between cancerous and noncancerous gastric lesions

Narrowed-spectrum Technologies in Endoscopic Imaging of The Upper Gastrointestinal Tract

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