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Endosc Int Open 2016; 04(12): E1280-E1285
DOI: 10.1055/s-0042-117629
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging

Hiroki Nakamura
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Shin-ei Kudo
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Masashi Misawa
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Shinichi Kataoka
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Kunihiko Wakamura
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Takemasa Hayashi
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Toyoki Kudo
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Yuichi Mori
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Kenichi Takeda
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Katsuro Ichimasa
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Hideyuki Miyachi
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Atushi Katagiri
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Fumio Ishida
1   Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
,
Haruhiro Inoue
2   Digestive Disease Center, Showa University, Koto-Toyosu Hospital, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted01 April 2016

accepted after revision13 September 2016

Publication Date:
10 November 2016 (online)

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Background and study aims: Magnifying narrow-band imaging (NBI) is useful for examination of colorectal lesions, and endocytoscopy (EC) allows diagnostic evaluation of structural atypia, nuclear atypia, and vascular structures of colorectal tumors. The aim of this study was to examine surface microvessels in deep invasive colorectal cancer using EC with a new NBI video processor system.

Patients and methods: We retrospectively assessed 132 colorectal neoplastic lesions: 81 adenomas, 18 intramucosal cancers, 4 submucosal slightly invasive cancers, and 29 submucosal deep invasive cancers. Detailed vascular findings commonly seen in submucosal deep invasive carcinomas included > 2-fold vasodilatation seen in adenomas, abnormal tortuosity and branching, loss of the micro-network pattern, caliber change in > 2 places in a single blood vessel, and blood vessels not visible in a line because they appear like a string of beads (beaded sign).

Results: Univariate analysis revealed 4 vascular findings that were strongly predictive of submucosal deep invasion: vasodilatation (odds ratio [OR] 9.31; 95 % confidence interval [CI] 3.57 – 24.30), loss of the micro-network pattern (OR 61.60; 95 % CI 17.87 – 212.29), caliber change (OR 35.7; 95 % CI 9.16 – 139.14), and the beaded sign (OR 45.90; 95 % CI 5.50 – 382.73).

Conclusions: Detailed assessment of ultra-magnified microvessels could improve the diagnostic performance for submucosal deep invasive cancer.

Study registration: UMIN-CTR000014033

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2017; 49(01): 97-97
DOI: 10.1055/s-0042-120942

 

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