Original Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2010; 16(14): 1727-1734
Published online Apr 14, 2010. doi: 10.3748/wjg.v16.i14.1727
Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer
Masakatsu Fukuzawa, Yutaka Saito, Takahisa Matsuda, Toshio Uraoka, Takao Itoi, Fuminori Moriyasu
Masakatsu Fukuzawa, Yutaka Saito, Takahisa Matsuda, Toshio Uraoka, Division of Endoscopy, National Cancer Center Hospital, Tokyo 1040045, Japan
Masakatsu Fukuzawa, Takao Itoi, Fuminori Moriyasu, Division of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 1600023, Japan
Toshio Uraoka, Department of Endoscopy, Okayama University Hospital, Okayama 7008558, Japan
Author contributions: Fukuzawa M, Saito Y and Matsuda T performed the research, designed the study, analyzed the data and wrote the manuscript; Uraoka T, Itoi T and Moriyasu F contributed to the discussion and reviewed the manuscript.
Correspondence to: Masakatsu Fukuzawa, MD, Division of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 1040045, Japan. masakatu8055@yahoo.co.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: November 30, 2009
Revised: January 20, 2010
Accepted: January 27, 2010
Published online: April 14, 2010
Abstract

AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis.

METHODS: We studied 112 ECC lesions [mucosal/submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnification colonoscopy pit pattern diagnosis.

RESULTS: Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense [odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis.

CONCLUSION: Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.

Keywords: Colorectal neoplasms; Narrow-band imaging; Microvasculature