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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 3/2024

03-01-2024 | Gastric Cancer | Original Article

l-Menthol for Color Difference Change Between Early Gastric Cancer and Surrounding Mucosa: A Prospective Study

Authors: Tsunetaka Kato, Takuto Hikichi, Masao Kobayakawa, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Ryoichiro Kobashi, Takumi Yanagita, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Hiroyuki Asama, Yuki Sato, Hiromasa Ohira

Published in: Digestive Diseases and Sciences | Issue 3/2024

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Abstract

Background

l-Menthol sprayed on early gastric cancer (EGC) has been reported to improve the visibility of the lesion. However, its impact when used in combination with novel image-enhanced endoscopy has not been investigated.

Aim

This study aimed to evaluate the visual effect of spraying l-menthol on EGC under linked color imaging (LCI).

Methods

This open-label, single-arm, prospective study investigated the color difference between EGC and the surrounding mucosa (ΔEG) before and after spraying l-menthol. The primary endpoint was the percentage of lesions with ΔEG ≥ 5 on LCI. The percentage of lesions with ΔEG  ≥ 5 on white light imaging (WLI) and blue laser imaging (BLI), ΔEG before and after spraying l-menthol, and percentage of lesions with increased ΔEG after spraying l-menthol constituted the secondary endpoints.

Results

Sixty patients were included in the final analysis. 100% lesions had ΔEG ≥ 5, both before and after spraying l-menthol on LCI, with similar results observed in WLI as well as BLI. The median ΔEG on LCI, WLI, and BLI increased after spraying l-menthol (LCI: 16.9 vs. 21.5, p < 0.01; WLI: 10.4 vs. 13.4, p < 0.01; BLI; 12.1 vs. 15.7, before and after, respectively, p < 0.01); and LCI demonstrated the highest percentage of lesions with increased ΔEG (LCI, WLI, and BLI: 98.3%, 81.7%, and 76.7%, respectively, p < 0.01).

Conclusion

Although spraying l-menthol did not improve the visibility of EGC under LCI observation, a significant increase in ΔEG was observed in LCI (jRCTs 021200027).
Appendix
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Metadata
Title
l-Menthol for Color Difference Change Between Early Gastric Cancer and Surrounding Mucosa: A Prospective Study
Authors
Tsunetaka Kato
Takuto Hikichi
Masao Kobayakawa
Jun Nakamura
Mika Takasumi
Minami Hashimoto
Ryoichiro Kobashi
Takumi Yanagita
Tadayuki Takagi
Rei Suzuki
Mitsuru Sugimoto
Hiroyuki Asama
Yuki Sato
Hiromasa Ohira
Publication date
03-01-2024
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2024
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-023-08239-y

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