Randomized Controlled Trial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2793-2799
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2793
Tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening
Yasushi Yamasaki, Ryuta Takenaka, Keisuke Hori, Koji Takemoto, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada, Shigeatsu Fujiki, Kazuhide Yamamoto
Yasushi Yamasaki, Ryuta Takenaka, Koji Takemoto, Shigeatsu Fujiki, Department of Gastroenterology, Tsuyama Chuo Hospital, Tsuyama, Okayama 708-0841, Japan
Yasushi Yamasaki, 2nd Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Keisuke Hori, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada, Division of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Yamasaki Y, Takenaka R, Hori K and Takemoto K designed the research; Yamasaki Y and Takenaka R performed the research; Yamasaki Y, Takenaka R, Hori K and Kawano S analyzed the data; Yamasaki Y and Takenaka R wrote the paper; Takenaka R, Kawahara Y and Okada H revised the paper; and Fujiki S and Yamamoto K approved the research.
Ethics approval: The study was reviewed and approved by the Tsuyama Chuo Hospital Institutional Review Board.
Clinical trial registration: This study is registered at https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000014135&type=summary&language=E. The registration identification number is UMIN 000012097.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare no conflict of interest associated with this manuscript.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yasushi Yamasaki, MD, Department of Gastroenterology, Tsuyama Chuo Hospital, 1756, Kawasaki, Tsuyama, Okayama 708-0841, Japan. yasshifive@yahoo.co.jp
Telephone: +81-868-218111 Fax: +81-868-218201
Received: August 29, 2014
Peer-review started: September 1, 2014
First decision: September 29, 2014
Revised: November 21, 2014
Accepted: December 19, 2014
Article in press: December 22, 2014
Published online: March 7, 2015
Processing time: 192 Days and 1.3 Hours
Abstract

AIM: To compare the tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening with that of lugol chromoendoscopy.

METHODS: We prospectively enrolled and analyzed 51 patients who were at high risk for esophageal cancer. All patients were divided into two groups: a magnifying narrow band imaging group, and a lugol chromoendoscopy group, for comparison of adverse symptoms. Esophageal cancer screening was performed on withdrawal of the endoscope. The primary endpoint was a score on a visual analogue scale for heartburn after the examination. The secondary endpoints were scale scores for retrosternal pain and dyspnea after the examinations, change in vital signs, total procedure time, and esophageal observation time.

RESULTS: The scores for heartburn and retrosternal pain in the magnifying narrow band imaging group were significantly better than those in the lugol chromoendoscopy group (P = 0.004, 0.024, respectively, ANOVA for repeated measures). The increase in heart rate after the procedure was significantly greater in the lugol chromoendoscopy group. There was no significant difference between the two groups with respect to other vital sign. The total procedure time and esophageal observation time in the magnifying narrow band imaging group were significantly shorter than those in the lugol chromoendoscopy group (450 ± 116 vs 565 ± 174, P = 0.004, 44 ± 26 vs 151 ± 72, P < 0.001, respectively).

CONCLUSION: Magnifying narrow band imaging endoscopy reduced the adverse symptoms compared with lugol chromoendoscopy. Narrow band imaging endoscopy is useful and suitable for esophageal cancer screening periodically.

Keywords: Narrow band imaging; Lugol; Adverse symptoms; Visual analogue scale score; Tolerability

Core tip: We conducted prospective randomized study to determine whether magnifying narrow band imaging (NBI) endoscopy would reduce the adverse symptoms compared with lugol chromoendoscopy. Total, 51 patients who were at high risk for esophageal cancer were enrolled. All patients were divided into two groups for comparison of adverse symptoms. The visual analogue scale scores for heartburn and retrosternal pain in the magnifying NBI group were significantly better than those in the lugol chromoendoscopy group. Magnifying NBI endoscopy reduced the adverse symptoms compared with lugol chromoendoscopy. NBI endoscopy is very useful and suitable for screening esophageal cancer patients periodically.