Abstract
Purpose:This study aimed to clarify the usefulness of magnified endoscopy with narrow-band imaging (NBI) to diagnose the degree of histological atypia and depth of invasion in colorectal neoplastic lesions.
Methods:A total of 247 colorectal lesions in 232 patients were analyzed. Each lesion was observed under magnified endoscopy with NBI and chromoendoscopy, and was classified according to the microvascular features observed on NBI system. The microvascular features were classified as follows:Type 1, invisible;Type 2, slight dilatation;Type 3V, regular arrangement of dilated vessels in villous lesions;Type 3I, irregular arrangement of dilated vessels;Type 4, disruptive and sparse vessels. The findings of NBI magnified endoscopy, together with the pit structure noted on NBI, were compared to chromoendoscopy findings.
Results:97% of lesions with microvascular Type 4 were submucosal massively invasive cancer lesions. With respect to differentiating intramucosal or submucosal slight invasion from submucosal massive invasion, the calculated sensitivity, specificity and accuracy of NBI magnified endoscopy were 78.9%, 95.9%, and 90.5%, respectively.;chromoendoscopy had 82.5% sensitivity, 95.9% specificity, and 91.6% accuracy.
Conclusion:NBI magnified endoscopy and magnified chromoendoscopy were almost equivalent in determining the depth of early colorectal cancer invasion. This result indicates that NBI magnified endoscopy is useful for determining treatment strategy.
