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Magnifying narrow-band imaging with acetic acid to diagnose early colorectal cancer.
World J Gastroenterol 2014; 20(43):16306-10WJ

Abstract

AIM

To evaluate the diagnostic characteristics of magnifying endoscopy with acetic acid spray and narrow-band imaging (MA-NBI) for early colorectal cancer.

METHODS

We conducted a prospective study to evaluate the diagnostic characteristics of MA-NBI in differentiating early colorectal adenocarcinomas from adenomas. To compare the results, we used magnifying endoscopy with NBI (M-NBI) and magnifying endoscopy with crystal violet staining (M-CV). The study was performed in 2 phases. In phase 1, 10 colonoscopists at our institution were shown still photographs of 35 colorectal polyps (24 adenocarcinomas and 11 adenomas) in M-NBI, MA-NBI, and M-CV. They made diagnostic predictions using a five-grade scoring evaluation. We plotted receiver operating characteristic curves and compared the areas under the curves (AUCs). In phase 2, colorectal polyps measuring ≥ 8 mm were prospectively enrolled. During real-time colonoscopy, one of the 7 colonoscopists scored the lesion as an adenocarcinoma or an adenoma and assigned a level of confidence to the prediction (high or low). We calculated the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each method and compared the proportions of high-confidence predictions.

RESULTS

In phase 1, the mean ± SD AUCs were 0.64 ± 0.031 in M-NBI, 0.71 ± 0.066 in MA-NBI, and 0.76 ± 0.059 in M-CV (P < 0.05 for M-NBI vs MA-NBI, P < 0.001 for M-NBI vs M-CV, and not significant for MA-NBI vs M-CV). In phase 2, 84 patients with 91 lesions (46 adenocarcinomas and 45 adenomas) were enrolled. The diagnostic characteristics were as follows: 73% accuracy, 85% sensitivity, 60% specificity, 68% PPV, and 79% NPV in M-NBI; 73% accuracy, 80% sensitivity, 64% specificity, 70% PPV, and 76% NPV in MA-NBI; and 73% accuracy, 83% sensitivity, 62% specificity, 69% PPV, and 78% NPV in M-CV. The proportions of high-confidence predictions were 57% in M-NBI, 75% in MA-NBI, and 76% in M-CV (P < 0.005 for M-NBI vs MA-NBI, P < 0.0005 for M-NBI vs M-CV, and P = 1.0 for MA-NBI vs M-CV).

CONCLUSION

MA-NBI is useful for differentiating early colorectal adenocarcinomas from adenomas.

Authors+Show Affiliations

Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.Norihiro Goto, Toshihiro Kusaka, Yumi Tomita, Hideyuki Tanaka, Yoshio Itokawa, Yorimitsu Koshikawa, Daisuke Yamaguchi, Yoshitaka Nakai, Shigehiko Fujii, Hiroyuki Kokuryu, Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto 615-8256, Japan.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

25473188

Citation

Goto, Norihiro, et al. "Magnifying Narrow-band Imaging With Acetic Acid to Diagnose Early Colorectal Cancer." World Journal of Gastroenterology, vol. 20, no. 43, 2014, pp. 16306-10.
Goto N, Kusaka T, Tomita Y, et al. Magnifying narrow-band imaging with acetic acid to diagnose early colorectal cancer. World J Gastroenterol. 2014;20(43):16306-10.
Goto, N., Kusaka, T., Tomita, Y., Tanaka, H., Itokawa, Y., Koshikawa, Y., ... Kokuryu, H. (2014). Magnifying narrow-band imaging with acetic acid to diagnose early colorectal cancer. World Journal of Gastroenterology, 20(43), pp. 16306-10. doi:10.3748/wjg.v20.i43.16306.
Goto N, et al. Magnifying Narrow-band Imaging With Acetic Acid to Diagnose Early Colorectal Cancer. World J Gastroenterol. 2014 Nov 21;20(43):16306-10. PubMed PMID: 25473188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnifying narrow-band imaging with acetic acid to diagnose early colorectal cancer. AU - Goto,Norihiro, AU - Kusaka,Toshihiro, AU - Tomita,Yumi, AU - Tanaka,Hideyuki, AU - Itokawa,Yoshio, AU - Koshikawa,Yorimitsu, AU - Yamaguchi,Daisuke, AU - Nakai,Yoshitaka, AU - Fujii,Shigehiko, AU - Kokuryu,Hiroyuki, PY - 2014/03/17/received PY - 2014/06/08/revised PY - 2014/07/11/accepted PY - 2014/12/5/entrez PY - 2014/12/5/pubmed PY - 2015/9/4/medline KW - Acetic acid KW - Colorectal cancer KW - Endoscopy KW - Narrow-band imaging KW - Neoplasia SP - 16306 EP - 10 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 43 N2 - AIM: To evaluate the diagnostic characteristics of magnifying endoscopy with acetic acid spray and narrow-band imaging (MA-NBI) for early colorectal cancer. METHODS: We conducted a prospective study to evaluate the diagnostic characteristics of MA-NBI in differentiating early colorectal adenocarcinomas from adenomas. To compare the results, we used magnifying endoscopy with NBI (M-NBI) and magnifying endoscopy with crystal violet staining (M-CV). The study was performed in 2 phases. In phase 1, 10 colonoscopists at our institution were shown still photographs of 35 colorectal polyps (24 adenocarcinomas and 11 adenomas) in M-NBI, MA-NBI, and M-CV. They made diagnostic predictions using a five-grade scoring evaluation. We plotted receiver operating characteristic curves and compared the areas under the curves (AUCs). In phase 2, colorectal polyps measuring ≥ 8 mm were prospectively enrolled. During real-time colonoscopy, one of the 7 colonoscopists scored the lesion as an adenocarcinoma or an adenoma and assigned a level of confidence to the prediction (high or low). We calculated the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each method and compared the proportions of high-confidence predictions. RESULTS: In phase 1, the mean ± SD AUCs were 0.64 ± 0.031 in M-NBI, 0.71 ± 0.066 in MA-NBI, and 0.76 ± 0.059 in M-CV (P < 0.05 for M-NBI vs MA-NBI, P < 0.001 for M-NBI vs M-CV, and not significant for MA-NBI vs M-CV). In phase 2, 84 patients with 91 lesions (46 adenocarcinomas and 45 adenomas) were enrolled. The diagnostic characteristics were as follows: 73% accuracy, 85% sensitivity, 60% specificity, 68% PPV, and 79% NPV in M-NBI; 73% accuracy, 80% sensitivity, 64% specificity, 70% PPV, and 76% NPV in MA-NBI; and 73% accuracy, 83% sensitivity, 62% specificity, 69% PPV, and 78% NPV in M-CV. The proportions of high-confidence predictions were 57% in M-NBI, 75% in MA-NBI, and 76% in M-CV (P < 0.005 for M-NBI vs MA-NBI, P < 0.0005 for M-NBI vs M-CV, and P = 1.0 for MA-NBI vs M-CV). CONCLUSION: MA-NBI is useful for differentiating early colorectal adenocarcinomas from adenomas. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25473188/Magnifying_narrow_band_imaging_with_acetic_acid_to_diagnose_early_colorectal_cancer_ L2 - http://www.wjgnet.com/1007-9327/full/v20/i43/16306.htm DB - PRIME DP - Unbound Medicine ER -