| Theme |
Narrow Band Imaging (NBI) / Fuji Intelligent Color Enhancement (FICE) and pit pattern in colon and rectum |
| Title |
Vascular pattern diagnosis with Narrow Band Imaging and pit pattern diagnosis of early colorectal cancer |
| Author |
Naoyuki Uragami |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Kaoru Suzuki |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Akiko Chino |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Teruhito Kishihara |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Akiyoshi Ishiyama |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Yutaka Fumizono |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Taishi Ogawa |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Masahiro Igarashi |
Division of Gastroenterology, Cancer Insititute Hospital |
| Author |
Hisashi Hosaka |
Division of Gastroenterology, Gunma Prefectural Cancer Center |
| [ Summary ] |
The so-called “pit pattern” classification system has been used to predict the nature of colorectal tumors with reliable results. Narrow Band Imaging (NBI) is a new technology developed to visualize the fine vascular structures and the crypt orifices of gastrointestinal mucosa without chromoendoscopy. In this article, two diagnostic methods, pit pattern diagnosis, as well as vascular pattern diagnosis for early colorectal cancer are compared. 130 early colorectal cancers were observed using the NBI system with an Olympus magnifying endoscope (magnified-NBI). The vascular patterns and pit patterns determined by magnified-NBI and chromoendoscopy were classified, and were compared to the histopathological diagnosis of cancer invasion and the both patterns retrospectively. Two categories such as regular type and irregular type vascular patterns were classified. The pathological diagnosis was Ca in situ in 68 lesions, SM slight invasion in 14 lesions and SM massive invasion in 48 lesions. 81 % of the regular patterns were mucosal lesions, 9 % of the regular patterns were SM massive lesions. While 79 % of the irregular patterns were SM massive lesions, 10% of the irregular patterns were mucosal lesions. The regular patterns included IIIs pit patterns in 10 % of the cases, IIIL pit patterns in 51 % , IV pit pattern in 18 % and VI pit pattern in 21 % . There was no VN pit pattern in the regular patterns. The regular patterns have little risk of SM massive invasion, because the VI pit pattern has a possibility of SM massive invasion. The irregular patterns included IIIL pits and IV pit pattern (4 %), VI pit pattern (52 %), VN pit pattern (44 %). The irregular patterns have mucosal lesions, because VI pit patterns have the possibility of being associated with mucosal lesion. These results suggest that more investigation of vascularity in lesions with VI pit patterns is needed to achieve better accuracy in vascular pattern diagnosis. |