Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer
Background/Aims: The aim of this study was to evaluate the diagnostic accuracy of magnifying narrow-band imaging (M-NBI) with histopathological confirmation in identifying the demarcation line (DL) of early gastric cancer (EGC). Methods: EGCs resected by endoscopic submucosal dissection after identi...
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| Veröffentlicht in: | Digestion 2019-01, Vol.100 (2), p.93-99 |
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| creator | Horii, Yusuke Dohi, Osamu Naito, Yuji Takayama, Shun Ogita, Kazuyuki Terasaki, Kei Nakano, Takahiro Majima, Atsushi Yoshida, Naohisa Kamada, Kazuhiro Uchiyama, Kazuhiko Ishikawa, Takeshi Takagi, Tomohisa Handa, Osamu Konishi, Hideyuki Yagi, Nobuaki Yanagisawa, Akio Itoh, Yoshito |
| description | Background/Aims: The aim of this study was to evaluate the diagnostic accuracy of magnifying narrow-band imaging (M-NBI) with histopathological confirmation in identifying the demarcation line (DL) of early gastric cancer (EGC). Methods: EGCs resected by endoscopic submucosal dissection after identifying the DL using M-NBI following histopathological confirmation were included. After determining the DL for the entire EGC lesion using M-NBI, at least 4 biopsies were taken from non-cancerous tissues outside the EGC lesion for histopathological confirmation. Results: A total of 330 EGCs were analyzed in this study. The rate of biopsy-negative and negative horizontal margin were 96.7% (319/330) and 97.9% (323/330) in EGC respectively. Tumors larger than 20 mm showed a higher risk for showing remnant cancer cells on biopsies taken outside the DL. Risk factors for a positive horizontal resection margin were tumor size > 20 mm and moderately or poorly differentiated adenocarcinomas. Conclusion: The assessment of demarcation of EGC using M-NBI was excellent in well-differentiated (WD) adenocarcinoma and lesions below 20 mm in size. However, histopathological confirmation is needed to assess the demarcation of non-WD adenocarcinomas and EGC over 20 mm in size. |
| doi_str_mv | 10.1159/000494053 |
| format | Article |
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Methods: EGCs resected by endoscopic submucosal dissection after identifying the DL using M-NBI following histopathological confirmation were included. After determining the DL for the entire EGC lesion using M-NBI, at least 4 biopsies were taken from non-cancerous tissues outside the EGC lesion for histopathological confirmation. Results: A total of 330 EGCs were analyzed in this study. The rate of biopsy-negative and negative horizontal margin were 96.7% (319/330) and 97.9% (323/330) in EGC respectively. Tumors larger than 20 mm showed a higher risk for showing remnant cancer cells on biopsies taken outside the DL. Risk factors for a positive horizontal resection margin were tumor size > 20 mm and moderately or poorly differentiated adenocarcinomas. Conclusion: The assessment of demarcation of EGC using M-NBI was excellent in well-differentiated (WD) adenocarcinoma and lesions below 20 mm in size. However, histopathological confirmation is needed to assess the demarcation of non-WD adenocarcinomas and EGC over 20 mm in size.</description><identifier>ISSN: 0012-2823</identifier><identifier>EISSN: 1421-9867</identifier><identifier>DOI: 10.1159/000494053</identifier><identifier>PMID: 30423568</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Aged ; Biopsy ; Endoscopic Mucosal Resection ; Female ; Gastric Mucosa - diagnostic imaging ; Gastric Mucosa - pathology ; Gastric Mucosa - surgery ; Gastroscopy - instrumentation ; Gastroscopy - methods ; Humans ; Male ; Margins of Excision ; Narrow Band Imaging - instrumentation ; Narrow Band Imaging - methods ; Original Paper ; Retrospective Studies ; Stomach Neoplasms - diagnostic imaging ; Stomach Neoplasms - surgery</subject><ispartof>Digestion, 2019-01, Vol.100 (2), p.93-99</ispartof><rights>2018 S. Karger AG, Basel</rights><rights>2018 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-34084942f45327aa2014ea5f228b2b989a05f73a81095059568cd65cef8a3d6f3</citedby><orcidid>0000-0003-2228-0405 ; 0000-0001-8964-8396</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30423568$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horii, Yusuke</creatorcontrib><creatorcontrib>Dohi, Osamu</creatorcontrib><creatorcontrib>Naito, Yuji</creatorcontrib><creatorcontrib>Takayama, Shun</creatorcontrib><creatorcontrib>Ogita, Kazuyuki</creatorcontrib><creatorcontrib>Terasaki, Kei</creatorcontrib><creatorcontrib>Nakano, Takahiro</creatorcontrib><creatorcontrib>Majima, Atsushi</creatorcontrib><creatorcontrib>Yoshida, Naohisa</creatorcontrib><creatorcontrib>Kamada, Kazuhiro</creatorcontrib><creatorcontrib>Uchiyama, Kazuhiko</creatorcontrib><creatorcontrib>Ishikawa, Takeshi</creatorcontrib><creatorcontrib>Takagi, Tomohisa</creatorcontrib><creatorcontrib>Handa, Osamu</creatorcontrib><creatorcontrib>Konishi, Hideyuki</creatorcontrib><creatorcontrib>Yagi, Nobuaki</creatorcontrib><creatorcontrib>Yanagisawa, Akio</creatorcontrib><creatorcontrib>Itoh, Yoshito</creatorcontrib><title>Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer</title><title>Digestion</title><addtitle>Digestion</addtitle><description>Background/Aims: The aim of this study was to evaluate the diagnostic accuracy of magnifying narrow-band imaging (M-NBI) with histopathological confirmation in identifying the demarcation line (DL) of early gastric cancer (EGC). Methods: EGCs resected by endoscopic submucosal dissection after identifying the DL using M-NBI following histopathological confirmation were included. After determining the DL for the entire EGC lesion using M-NBI, at least 4 biopsies were taken from non-cancerous tissues outside the EGC lesion for histopathological confirmation. Results: A total of 330 EGCs were analyzed in this study. The rate of biopsy-negative and negative horizontal margin were 96.7% (319/330) and 97.9% (323/330) in EGC respectively. Tumors larger than 20 mm showed a higher risk for showing remnant cancer cells on biopsies taken outside the DL. Risk factors for a positive horizontal resection margin were tumor size > 20 mm and moderately or poorly differentiated adenocarcinomas. Conclusion: The assessment of demarcation of EGC using M-NBI was excellent in well-differentiated (WD) adenocarcinoma and lesions below 20 mm in size. However, histopathological confirmation is needed to assess the demarcation of non-WD adenocarcinomas and EGC over 20 mm in size.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Endoscopic Mucosal Resection</subject><subject>Female</subject><subject>Gastric Mucosa - diagnostic imaging</subject><subject>Gastric Mucosa - pathology</subject><subject>Gastric Mucosa - surgery</subject><subject>Gastroscopy - instrumentation</subject><subject>Gastroscopy - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Narrow Band Imaging - instrumentation</subject><subject>Narrow Band Imaging - methods</subject><subject>Original Paper</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - diagnostic imaging</subject><subject>Stomach Neoplasms - surgery</subject><issn>0012-2823</issn><issn>1421-9867</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkD1PwzAQhi0EglIY2BGyxAJDwJ-pM0Jb2koFFpijq2NXgSQudioUfj2JUjoxWWc9997dg9AFJXeUyuSeECISQSQ_QAMqGI0SFY8O0YAQyiKmGD9BpyF8dGUi-DE64UQwLmM1QGZqba5BN9hZ_AzrKrdNXq3xC3jvvvEjVBlelLDu_qzzeGKKvDJQd_Xc-fzHVTUUbadvkdCFTMEXDZ5BqH2u8RgqbfwZOrJQBHO-e4fo_Wn6Np5Hy9fZYvywjLQgpI64IKo9hFkhORsBMEKFAWkZUyu2SlQCRNoRB0VJIolM2gt0FkttrAKexZYP0U2fu_Hua2tCnZZ50KYooDJuG1JGORdcqtbCEN32qPYuBG9suvF5Cb5JKUk7q-neaste7WK3q9Jke_JPYwtc98Bn68H4PTBZzPqIdJN1213-S-2m_AIaLoU4</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Horii, Yusuke</creator><creator>Dohi, Osamu</creator><creator>Naito, Yuji</creator><creator>Takayama, Shun</creator><creator>Ogita, Kazuyuki</creator><creator>Terasaki, Kei</creator><creator>Nakano, Takahiro</creator><creator>Majima, Atsushi</creator><creator>Yoshida, Naohisa</creator><creator>Kamada, Kazuhiro</creator><creator>Uchiyama, Kazuhiko</creator><creator>Ishikawa, Takeshi</creator><creator>Takagi, Tomohisa</creator><creator>Handa, Osamu</creator><creator>Konishi, Hideyuki</creator><creator>Yagi, Nobuaki</creator><creator>Yanagisawa, Akio</creator><creator>Itoh, Yoshito</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2228-0405</orcidid><orcidid>https://orcid.org/0000-0001-8964-8396</orcidid></search><sort><creationdate>20190101</creationdate><title>Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer</title><author>Horii, Yusuke ; Dohi, Osamu ; Naito, Yuji ; Takayama, Shun ; Ogita, Kazuyuki ; Terasaki, Kei ; Nakano, Takahiro ; Majima, Atsushi ; Yoshida, Naohisa ; Kamada, Kazuhiro ; Uchiyama, Kazuhiko ; Ishikawa, Takeshi ; Takagi, Tomohisa ; Handa, Osamu ; Konishi, Hideyuki ; Yagi, Nobuaki ; Yanagisawa, Akio ; Itoh, Yoshito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-34084942f45327aa2014ea5f228b2b989a05f73a81095059568cd65cef8a3d6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Endoscopic Mucosal Resection</topic><topic>Female</topic><topic>Gastric Mucosa - diagnostic imaging</topic><topic>Gastric Mucosa - pathology</topic><topic>Gastric Mucosa - surgery</topic><topic>Gastroscopy - instrumentation</topic><topic>Gastroscopy - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Margins of Excision</topic><topic>Narrow Band Imaging - instrumentation</topic><topic>Narrow Band Imaging - methods</topic><topic>Original Paper</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - diagnostic imaging</topic><topic>Stomach Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horii, Yusuke</creatorcontrib><creatorcontrib>Dohi, Osamu</creatorcontrib><creatorcontrib>Naito, Yuji</creatorcontrib><creatorcontrib>Takayama, Shun</creatorcontrib><creatorcontrib>Ogita, Kazuyuki</creatorcontrib><creatorcontrib>Terasaki, Kei</creatorcontrib><creatorcontrib>Nakano, Takahiro</creatorcontrib><creatorcontrib>Majima, Atsushi</creatorcontrib><creatorcontrib>Yoshida, Naohisa</creatorcontrib><creatorcontrib>Kamada, Kazuhiro</creatorcontrib><creatorcontrib>Uchiyama, Kazuhiko</creatorcontrib><creatorcontrib>Ishikawa, Takeshi</creatorcontrib><creatorcontrib>Takagi, Tomohisa</creatorcontrib><creatorcontrib>Handa, Osamu</creatorcontrib><creatorcontrib>Konishi, Hideyuki</creatorcontrib><creatorcontrib>Yagi, Nobuaki</creatorcontrib><creatorcontrib>Yanagisawa, Akio</creatorcontrib><creatorcontrib>Itoh, Yoshito</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horii, Yusuke</au><au>Dohi, Osamu</au><au>Naito, Yuji</au><au>Takayama, Shun</au><au>Ogita, Kazuyuki</au><au>Terasaki, Kei</au><au>Nakano, Takahiro</au><au>Majima, Atsushi</au><au>Yoshida, Naohisa</au><au>Kamada, Kazuhiro</au><au>Uchiyama, Kazuhiko</au><au>Ishikawa, Takeshi</au><au>Takagi, Tomohisa</au><au>Handa, Osamu</au><au>Konishi, Hideyuki</au><au>Yagi, Nobuaki</au><au>Yanagisawa, Akio</au><au>Itoh, Yoshito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer</atitle><jtitle>Digestion</jtitle><addtitle>Digestion</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>100</volume><issue>2</issue><spage>93</spage><epage>99</epage><pages>93-99</pages><issn>0012-2823</issn><eissn>1421-9867</eissn><abstract>Background/Aims: The aim of this study was to evaluate the diagnostic accuracy of magnifying narrow-band imaging (M-NBI) with histopathological confirmation in identifying the demarcation line (DL) of early gastric cancer (EGC). Methods: EGCs resected by endoscopic submucosal dissection after identifying the DL using M-NBI following histopathological confirmation were included. After determining the DL for the entire EGC lesion using M-NBI, at least 4 biopsies were taken from non-cancerous tissues outside the EGC lesion for histopathological confirmation. Results: A total of 330 EGCs were analyzed in this study. The rate of biopsy-negative and negative horizontal margin were 96.7% (319/330) and 97.9% (323/330) in EGC respectively. Tumors larger than 20 mm showed a higher risk for showing remnant cancer cells on biopsies taken outside the DL. Risk factors for a positive horizontal resection margin were tumor size > 20 mm and moderately or poorly differentiated adenocarcinomas. Conclusion: The assessment of demarcation of EGC using M-NBI was excellent in well-differentiated (WD) adenocarcinoma and lesions below 20 mm in size. However, histopathological confirmation is needed to assess the demarcation of non-WD adenocarcinomas and EGC over 20 mm in size.</abstract><cop>Basel, Switzerland</cop><pmid>30423568</pmid><doi>10.1159/000494053</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2228-0405</orcidid><orcidid>https://orcid.org/0000-0001-8964-8396</orcidid></addata></record> |
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| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - pathology Adenocarcinoma - surgery Aged Biopsy Endoscopic Mucosal Resection Female Gastric Mucosa - diagnostic imaging Gastric Mucosa - pathology Gastric Mucosa - surgery Gastroscopy - instrumentation Gastroscopy - methods Humans Male Margins of Excision Narrow Band Imaging - instrumentation Narrow Band Imaging - methods Original Paper Retrospective Studies Stomach Neoplasms - diagnostic imaging Stomach Neoplasms - surgery |
| title | Efficacy of Magnifying Narrow Band Imaging for Delineating Horizontal Margins of Early Gastric Cancer |
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