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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(12): E1877-E1885
DOI: 10.1055/a-1583-9196
Original article

Effect of adding magnifying BLI, magnifying NBI, and iodine staining to white light imaging in diagnosis of early esophageal cancer

Kenro Kawada
1   Tokyo Medical and Dental University, Department of Gastrointestinal Surgery, Tokyo, Japan, Saitama Cancer center, Department of Gastroenterology
,
Miwako Arima
2   Saitama Cancer center, Department of Gastroenterology, Ina-machi, Kitaadachi, Japan
,
Ryoji Miyahara
3   Nagoya University Graduate School of Medicine, Department of Gastroenterology and Hepatology, Nagoya, Japan
,
Mika Tsunomiya
2   Saitama Cancer center, Department of Gastroenterology, Ina-machi, Kitaadachi, Japan
,
Masakazu Kikuchi
3   Nagoya University Graduate School of Medicine, Department of Gastroenterology and Hepatology, Nagoya, Japan
,
Fumiko Yamamoto
3   Nagoya University Graduate School of Medicine, Department of Gastroenterology and Hepatology, Nagoya, Japan
,
Akihiro Hoshino
1   Tokyo Medical and Dental University, Department of Gastrointestinal Surgery, Tokyo, Japan, Saitama Cancer center, Department of Gastroenterology
,
Yasuaki Nakajima
1   Tokyo Medical and Dental University, Department of Gastrointestinal Surgery, Tokyo, Japan, Saitama Cancer center, Department of Gastroenterology
,
Yusuke Kinugasa
1   Tokyo Medical and Dental University, Department of Gastrointestinal Surgery, Tokyo, Japan, Saitama Cancer center, Department of Gastroenterology
,
Tatsuyuki Kawano
4   Soka Municipal hospital, Department of Surgery, Soka city, Saitama, Japan
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Abstract

Background and study aims We investigated the effect of adding magnifying blue laser imaging (BLI), magnifying narrow-band imaging (NBI), and iodine staining to white light imaging in diagnosis of early esophageal squamous cell carcinoma (EESCC) in high-risk patients.

Patients and methods Between May 2013 and March 2016, two parallel prospective cohorts of patients received either primary WLI followed by NBI-magnifying endoscopy (ME) or primary WLI followed by BLI-ME, were studied. At the end of screening, both groups underwent iodine staining. The percentage of patients with newly detected esophageal malignant lesions in each group and the diagnostic ability of image-enhanced endoscopy (IEE)-ME were evaluated.

Results There are 258 patients assigned to the NBI-ME group and 254 patients assigned to the BLI-ME group. The percentage of patients with one or more malignant lesions detected in the WLI + NBI-ME examination was similar in the WLI + BLI-ME examination (15 of 258 patients or 5.81 % vs. 14 of 254 patients or 5.51 %). However, four of 19 lesions in the NBI-ME group and six of 21 lesions in the BLI-ME group were overlooked and were detected by iodine staining. NBI-ME and BLI-ME showed similar accuracy in differentiation of cancerous lesions from non-cancerous lesions in diagnosis of EESCC (NBI/BLI: sensitivity, 87.5/89.5; specificity, 78.9/76.6; accuracy, 80.8/79.5; positive predictive value, 53.8/53.1; negative predictive value, 95.7/96.1).

Conclusions Both NBI and BLI were useful for detection of EESCC. However, because some lesions were overlooked by even NBI and BLI, high-risk patients may benefit from use of iodine staining during endoscopic screening of EESCC (UMIN000023596).



Publication History

Received: 31 August 2020

Accepted: 03 August 2021

Article published online:
14 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2022; 54(01): 105-105
DOI: 10.1055/a-1641-8876

 

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