Magnifying endoscopy with narrow-band imaging is useful in differentiating gastric cancer from matched adenoma in white light imaging

• Published in: Scientific reports Vol. 12; no. 1; p. 8349
• Main Authors: Tamura, Naoki, Sakaguchi, Yoshiki, Furutani, Wakiko, Matsui, Maki, Nagao, Sayaka, Sakuma, Nobuyuki, Fukagawa, Kazushi, Miura, Yuko, Mizutani, Hiroya, Ohki, Daisuke, Kataoka, Yosuke, Saito, Itaru, Ono, Masayoshi, Minatsuki, Chihiro, Tsuji, Yosuke, Ono, Satoshi, Kodashima, Shinya, Abe, Hiroyuki, Ushiku, Tetsuo, Yamamichi, Nobutake, Koike, Kazuhiko, Fujishiro, Mitsuhiro
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19.05.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4020/2223; 692/699/67/1504/1829; Adenocarcinoma - diagnostic imaging; Adenoma; Adenoma - diagnostic imaging; Adenoma - pathology; Cancer; Carcinoma; Differential diagnosis; Endoscopy; Endoscopy, Gastrointestinal - methods; Gastric cancer; Humanities and Social Sciences; Humans; Microvasculature; multidisciplinary; Narrow Band Imaging - methods; Science; Science (multidisciplinary); Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - pathology; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-12315-0

This study assessed the effect of magnifying endoscopy with narrow-band imaging (M-NBI) on the endoscopic differential diagnosis between intramucosal gastric carcinomas and adenomas with matched characteristics. Associations between magnified endoscopic findings and pathological high-grade cellular and architectural atypia were also investigated. In total, the records of 50 adenomas and 50 intramucosal well-differentiated adenocarcinomas matched by tumor size (≥ 20 mm or < 20 mm), shape (depression or non-depression), and color (red or non-red) were extracted. Fourteen endoscopists diagnosed adenoma or cancer in the 100 cases with conventional white light imaging (C-WLI), then did the same with C-WLI + M-NBI.The cancer diagnostic sensitivity, specificity, and accuracy were assessed. The sensitivity of C-WLI + M-NBI for cancer diagnosis was 79.9% compared to 71.6% with C-WLI (p < 0.001). There were no significant differences in specificity (40.1% vs. 36.3%, p = 0.296) and accuracy (55.9% vs. 58.1%, p = 0.163). High-grade cytological or architectural atypia was diagnosed more often with irregular microvascular pattern (IMVP) or microsurface pattern (IMSP), respectively, than the low-grade forms. In conclusion, IMVP and IMSP correlate with high-grade cytological and architectural atypia. M-NBI is useful in differentiating intramucosal carcinoma from adenoma and can reduce underdiagnosis of cancer.