ROLE OF NARROW BAND IMAGING FOR DIAGNOSIS OF EARLY-STAGE ESOPHAGOGASTRIC CANCER: CURRENT CONSENSUS OF EXPERIENCED ENDOSCOPISTS IN ASIA-PACIFIC REGION
ROLE OF NARROW BAND IMAGING FOR DIAGNOSIS OF EARLY-STAGE ESOPHAGOGASTRIC CANCER: CURRENT CONSENSUS OF EXPERIENCED ENDOSCOPISTS IN ASIA-PACIFIC REGION
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DOI：
10.1111/j.1443-1661.2011.01119.x
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发表时间：
2011-05-01
影响因子：
5.3
通讯作者：
Yao, Takashi
中科院分区：
文献类型：
--
作者：
Uedo, Noriya;Fujishiro, Mitsuhiro;Yao, Takashi
在亚洲国家，鳞状细胞癌是最常见的食道癌类型，而胃癌的发病率一直处于停滞状态。为了综合现有信息并阐明窄带成像(NBI)在诊断浅表食管鳞癌(SESCC)和早期胃癌(EGC)中的临床益处，来自亚太国家的9名专家小组举行了一次共识会议。专家的一致意见表明，解释病变的血管结构和表面结构以及内窥镜图像的适当处理器设置非常重要。变焦内窥镜对于SESCC的检测并不是绝对必要的，但放大观察为确定已发现的食道和胃内病变提供了有价值的信息。一般而言，NBI对于SESCC的检测和表征是有用的，而它主要有益于EGC的表征。色素内窥镜在某些情况下仍有价值，如用卢戈氏染色确定SESCC的范围，或用靛红检测和描绘EGC。在常规检查中，NBI可以取代染色内窥镜，因为它使用方便，增加了常规WLI的信息量，但在做出最终诊断时不能消除染色内窥镜，为治疗决策提供依据。因此，NBI或放大NBI的益处是特定于器官和检查目的的，因此应该了解最佳的适应症和用法，以获得最大的临床益处。
In Asian countries, squamous cell carcinoma is the most common type of esophageal cancer, and the incidence of gastric cancer remains have plateaued. To synthesize current information and to illustrate its clinical benefit of narrow band imaging (NBI) for diagnosis of superficial esophageal squamous carcinoma (SESCC) and early gastric cancer (EGC), a consensus conference was held by a panel of nine experts from Asian-Pacific countries. The expert's agreement suggested importance of interpretation of both vascular architecture and surface structure of the lesions and proper processor settings for endoscopic images. Zoom endoscopy was not regarded as absolutely necessary for detection of SESCC, but magnifying observation provided valuable information for characterization of detected lesions in the esophagus and the stomach. In general, NBI is useful for detection and characterization of SESCC, whereas it is beneficial mainly for characterization of EGC. Chromoendoscopy was found to be still worthwhile in certain situations, such as determination of the extent of SESCC by Lugol's staining, or detection and delineation of EGC by indigo carmine. NBI could replace chromoendoscopy in routine examination because it is easy to use and adds much information to conventional WLI, but it cannot eliminate chromoendoscopy when we make a final diagnosis for treatment decision-making. Consequently, the benefit of NBI or magnifying NBI is specific for the organ and the purpose of the examination, thus optimum indication and usage should be understood for maximum clinical benefit.