Linked color imaging technology facilitates early detection of flat gastric cancers
Linked color imaging technology facilitates early detection of flat gastric cancers
复制标题
DOI：
10.1007/s12328-015-0612-9
复制
发表时间：
2015-12-01
影响因子：
1
通讯作者：
Yamamoto, Hironori
中科院分区：
文献类型：
--
作者：
Fukuda, Hisashi;Miura, Yoshimasa;Yamamoto, Hironori
传统内窥镜检查可能会漏掉扁平早期胃癌 (0-IIb)，因为它们可能不可见。我们治疗了一名传统白光内窥镜 (WLE) 漏诊的同步扁平早期胃癌患者。一名 74 岁的日本男性因胃窦后壁凹陷型早期胃癌 (0-IIc) 被转诊接受内镜粘膜下剥离术 (ESD)。连锁彩色成像 (LCI) 在远端体部和幽门前区域检测到两个直径分别为 30 毫米和 10 毫米的扁平红色病变 (0-IIb)，这是传统 WLE 无法检测到的。 LCI 无需放大即可清楚地显示恶性病变与周围粘膜之间的分界线。怀疑扁平早期胃癌，因为使用放大蓝色激光成像（BLI）显示两个病变具有不规则的表面图案。通过激光 WLE 沿胃窦大弯检测到额外的凹陷病变 (0-IIc)。放大 BLI 提示存在恶性病变。活检标本的组织学检查显示所有四个病变均存在非典型腺体。对这些病变进行了 ESD。切除标本的病理检查证实所有四个病灶均存在局限于粘膜的分化良好的腺癌。使用新的内窥镜技术，扁平的早期胃癌变得清晰可见。
Conventional endoscopy can miss flat early gastric cancers (0-IIb) because they may not be visible. We treated a patient with synchronous flat early gastric cancers missed by conventional white-light endoscopy (WLE). A 74-year-old Japanese male was referred for endoscopic submucosal dissection (ESD) of a depressed-type early gastric cancer (0-IIc) on the posterior wall of the antrum. Linked color imaging (LCI) detected two flat reddish lesions (0-IIb) measuring 30 mm and 10 mm in diameter in the distal body and prepyloric area, respectively, which had not been detected by conventional WLE. LCI clearly demonstrated the line of demarcation between the malignant lesion and the surrounding mucosa without magnification. Flat early gastric cancers were suspected because both lesions had irregular surface patterns using magnifying blue laser imaging (BLI). An additional depressed lesion (0-IIc) was detected by laser WLE along the greater curvature in the antrum. Magnifying BLI suggested a malignant lesion. Histological examination of biopsy specimens revealed atypical glands in all four lesions. ESD of these lesions was performed. Pathological examination of the resected specimens confirmed well-differentiated adenocarcinoma localized to the mucosa in all four lesions. Flat early gastric cancers became clearly visible using new endoscopic technology.