| Theme | Frontier of image diagnosis for colorectal carcinoma | |
|---|---|---|
| Title | Observation of capillary pattern might be helpful finding to diagnose of depth of invasion in early colon cancer by using NBI system | |
| Publish Date | 2009/03 | |
| Author | Shoichi Saito | 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 | Hiroyuki Aihara | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hiroshi Arakawa | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Hisao Tajiri | Division of Gastroenterology and Hepatology, Department of Internal Medicine/Department of Endoscopy, The Jikei University School of Medicine |
| Author | Masahiro Ikegami | Department of Pathology, The Jikei University School of Medicine |
| [ Summary ] | NBI (Narrow Band Imaging) makes it possible to emphasize the imaging of mucosal micro-vessels in the superficial layer of colon tumors. The architecture of micro-vessels was classified into four types, endoscopically. Type 1 consisted of nonvisible dilatated capillary vessels. Type 2 was observed as slightly dilated capillary vessels providing running circulation to tumorous glands. Type 3 was divided into two types. The first was type 3V (Villous pattern), which had a regular arrangement of dilated capillaries in the neoplastic glands associated with villous components. Another was type 3I (Irregular pattern), was seen to have an irregular arrangement of dilated capillaries. Type 4 consisted of those with disrupted capillary vessels. 92.7% of hyperplastic polyps were shown to be type 1. In contrast, neoplastic lesion exhibited dilated micro-vessel tumorous lesions. 75.2% of tubular adenomas exhibited level type 2 and the remaining 17.2% consisted of type 3. Most intramucosal cancer was shown to be type 3. In case of submucosal invasive cancer, more than 90% of SM-s (less than 1,000μm invaded） cancer was considered to be type 3. This was especially so with type 3I comprising 72.2% of these cases. More than half of SM-m (more than 1,000μm deeper) cases were shown to be type 4. NBI magnifying endoscopy and magnified chromoendoscopy exhibited nearly equivalent results in terms of determining depth of early colon cancer invasion. Therefore, we concluded the use of NBI magnifying observation is very useful in diagnosing colon cancer, and deciding on method of resection. | |