| Theme |
Image-enhanced endoscopy -- Current status and significance of colorectal NBI and BLI |
| Title |
Role of magnifying observation using NBI systems for colonic neoplasms |
| Author |
Shoichi Saito |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Hiroko Inomata |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Daisuke Ide |
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| Author |
Naoto Tamai |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Tomohiko R Ohya |
Department of Endoscopy, The Jikei University School of Medicine |
| Author |
Toshiki Nikami |
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| Author |
Tomohiro Kato |
Department of Endoscopy, The Jikei University School of Medicine / Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| Author |
Hisao Tajiri |
Department of Endoscopy, The Jikei University School of Medicine / Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine |
| Author |
Masahiro Ikegami |
Department of Pathology, The Jikei University School of Medicine |
| [ Summary ] |
The usefulness of employing NBI systems with magnified observation has often been reported for viewing upper and lower GI tracts in recent years. We propose a classification system employing four types of findings for capillary network patterns as seen with NBI observation. Type 1 has non-observable dilation of the capillary vessels. Type 2 consists of slightly dilated capillary vessels, which sustained tumors. Type 3 consists of two categories : 3V (villous pattern) with regular arrangement of dilated capillaries in neoplastic glands with villous components, and 3I (irregular pattern) with irregular arrangement of dilated capillaries. Type 4 consists of disrupted capillary vessels. 85.9 % of patients in the pattern 1 group exhibited hyperplastic polyps. In contrast, approximately 50 % of tubular adenomas were associated with dilated micro-vessels and seen to have pattern 2 involvement. A majority of intramucosal cancer (66.9 %) was shown to be type 3V. In cases of submucosal invasive cancer, three fourths (75.2 %) were shown to be type 3I. However, about half cases, which are showing pattern 3I were indication for endoscopic treatment. The other half of these cases consisted of those who were candidates for laparoscopic surgery. Therefore, it is often necessary to conduct further examinations using dye staining with indigocarmine and crystal violet solutions to determine lesions with 3I patterns to make decisions on final treatment methods. Cases with SM-M cancer had a 94.5 % rate of exhibiting pattern 4 conditions. NBI magnifying endoscopy and magnified chromoendoscopy were nearly equivalent in terms of obtaining results to determine depth of early colon cancer invasion. As a result, we concluded that using NBI magnifying observation is a useful modality for determining the methods for treatment of colon cancer. |