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Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms

Intestinal Research 2020년 18권 1호 p.107 ~ 114
 ( Gonai Takahiro ) - Iwate Medical University School of Medicine Department of Internal Medicine

 ( Kawasaki Keisuke ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Nakamura Shotaro ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Yanai Shunichi ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Akasaka Risaburo ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Sato Kunihiko ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Toya Yousuke ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Asakura Kensuke ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Urushikubo Jun ) - Iwate Medical University School of Medicine Department of Internal Medicine
 ( Fujita Yasuko ) - Iwate Medical University School of Medicine Department of Pathology

Abstract


Background/Aims: Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.

Methods: We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.

Results: The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P<0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P<0.05).

Conclusions: The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

키워드

Microvascular density; Narrow band imaging; Colorectal neoplasms; Colonoscopy
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