Uterine Cervical Neoplasm Diagnosed by Flexible Magnifying Endoscopy with Narrow Band Imaging

Abstract

When detected early, uterine cervical cancer is one of the most successfully treatable forms of cancer. The diagnostic accuracy of the standard method, the Pap smear test followed by colposcopy, remains unsatisfactory. To improve detection of early-stage cervical cancer, new diagnostic tools for uterine cervical intraepithelial neoplasm (CIN) need to be developed. Magnifying endoscopy with narrow- band imaging (ME-NBI), which allows the visualization of the micro-structure as well as micro-vascularity of the mucosal surface, has excellent diagnostic ability for early gastrointestinal neoplasms. In our previous investigation, ME-NBI was efficacious for diagnosis of CIN. We herein report two notable cases of CIN3 that were diagnosed by ME-NBI that were not detected by colposcopy. These cases illustrate the usefulness of ME-NBI for diagnosis of early-stage uterine cervical neoplasms.

Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow‑band imaging technique: A systematic review

“…Of the selected studies, 10 (32%) were case reports (9-18), 19 (61.2%) were prospective studies (11,12,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) and two studies (6.4%) were randomized controlled trials (33,34). The selected studies had publication dates ranging from 2007 to 2020.…”

“…2. The years with the highest frequency of publications were 2010 and 2011 with 5 studies produced each year and the country which produced the highest number of studies was Japan with 11 studies (13,18,21,22,28,(31)(32)(33)35), followed by Italy with 8 studies (9,10,(15)(16)(17)19,20,36).…”

“…A total of 9 studies were included in the review, dating from 2010 to 2020. Of these, four studies were prospective studies (31,32,35,39) and five studies were case reports (14)(15)(16)(17)(18). The total number of patients was 156 and the mean age was 43.3±17.25 years.…”

“…The total number of patients was 156 and the mean age was 43.3±17.25 years. Uterine cervical pathology was investigated with NBI in five studies (14,18,31,32,35) and peritoneal implants were investigated with NBI in four studies (15)(16)(17)39). The vascular pattern of lesions was examined in 21 patients with early and in situ cervical adenocarcinoma using NBI (13).…”

“…In addition, NBI proved to be useful in the laparoscopic detection of early peritoneal implants in three case reports (15)(16)(17). Kobara et al (18) indicated that NBI increased the sensitivity, specificity, accuracy and positive predictive value for the detection of cervical intraepithelial lesions-3 (CIN-3) in comparison with conventional colposcopy. NBI with a gastroscope assisted the detection of high-grade cervical intraepithelial lesions in two patients, while these lesions were not identified by conventional colposcopy (18,35).…”