ENDOCYTOSCOPIC DIAGNOSIS OF SUPERFICIAL CANCER OF THE UPPER GASTROINTESTINAL TRACT
2019 Volume 61 Issue 8 Pages 1513-1522
Details
2019 Volume 61 Issue 8 Pages 1513-1522
The endocytoscopy system (ECS) enables observation of surface epithelial cells with vital staining, thus realizing the concept of optical biopsy. The first-generation ECS was developed in 2003, and four ECS prototypes have been developed to solve the problems of each prototype. The fourth-generation ECS (GIF-H290EC) allows high-definition observation under 500 times magnification. The GIF-H290EC was released on the market in 2018. Concerning the esophagus, ECS can clearly demonstrate the shape of cell nuclei. Accuracy of more than 90% for distinguishing esophageal malignancy was noted based on observation of both “nuclear density” and “nuclear atypia”.
Concerning the stomach, removal of surface mucous still remains as a considerable problem. Devising the dye for vital staining has improved the staining ability for the stomach and has allowed us to assess “structural destruction”, “loss of polarity of cell arrangement”, and “cell abnormality”.
Only a few articles on ECS observation of the duodenum have been published. However, characteristic findings that reflect the histological features can be obtained in cases with celiac disease and duodenal neoplasms.
ECS enables pathological diagnosis in vivo in real time. Using ECS, we can perform “microscopic diagnosis” in addition to the conventional “macroscopic diagnosis”.
