| Theme | Colonoscopy for the super-elderly | |
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| Title | NBI colorectal magnifying endoscopic classification proposed by Japan NBI Expert Team (JNET) | |
| Publish Date | 2015/01 | |
| Author | Yasushi Sano | |
| Author | Shinji Tanaka | |
| Author | Shin-ei Kudo | |
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| [ Summary ] | Although magnifying chromoendoscopy has been a reliable diagnostic tool, narrow-bandimaging (NBI) has been developed in Japan since 1999. It has now replaced the major role in chromoendoscopy because of its convenience and simplicity. NBI with magnification colonoscopy is useful for histological predictions, or for estimating the depth of cancer invasion. At this time, some NBI colorectal magnifying classifications have been reported such as the Sano, Hiroshima, Showa and Jikei classifications and have exhibited their usefulness in daily practice. On the other hand, the International Colon Tumor Interesting Group (CTNIG) reported the NBI International Colorectal Endoscopic (NICE) classification, proposed for use by endoscopists who do or do not use magnifying endoscopes. Although these classifications work in scientific terms in daily practice, some Japanese gastroenterologists are confused due to different terminology related to findings, including different approachs using vessel and surface pattern findings. To standardize these diagnostic strategies, the Japan NBI Expert Team (JNET) was organized in 2011. According to the results of a web based prospective trial, the JNET achieved consensus regarding NBI classification using magnification by the modified Delphi method. In 2014, the JNET proposed the NBI colorectal magnifying endoscopic classification. The classification proposed by JNET is a simple category classification system consisting of types 1, 2A, 2B, and 3 and is based on two characteristics : (i) microvascular architecture ; and (ii) surface patterns. Type 1 is considered an index for hyperplastic lesions. Type 2A is an index for adenomas. Type 2B is an index for mucosal/SM scanty invasive carcinoma. Type 3 is an index for deep SM invasive carcinoma. Further investigation is required to validate efficacy of the JNET classification in community practice. |
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