Original ResearchClinical—Alimentary TractMagnifying Narrowband Imaging Is More Accurate Than Conventional White-Light Imaging in Diagnosis of Gastric Mucosal Cancer
Section snippets
Study Design and Participants
This randomized, controlled, open-label, multicenter trial was conducted at 9 centers in Japan. This study was conducted according to the Standards for the Reporting of Diagnostic Accuracy Studies (STARD) initiative16 and the Declaration of Helsinki.
The frequency of synchronous or metachronous multiple gastric cancers was reported as 3 to 5 per 100 patient-years,17, 18, 19 which is higher than the incidence of gastric cancer in the general population. In other words, patients with gastric
Results
Between June 2008 and May 2010, 1365 patients were enrolled in the study. Eight patients refused to participate and 4 were registered twice; therefore, the remaining 1353 patients were registered correctly and underwent endoscopic screening. Screening was discontinued for 2 patients because of a large amount of residual digesta in the stomach and a severe vomiting reflex. Endoscopic screening was completed for the remaining 1351 patients.
Of the screened patients, 362 (26.8%) had newly detected
Discussion
In this multicenter randomized trial, we compared the diagnostic yield of C-WLI with that of M-NBI for small gastric cancers. The primary aim of this study was to compare directly the real-time diagnostic accuracy of 2 randomly assigned endoscopic modalities. One was the worldwide standard method of C-WLI; the other was M-NBI, which is the most advanced imaging method at present. This end point is the most important aspect of this study, because if C-WLI proves superior to M-NBI, such advanced
Acknowledgments
Gastric NBI Study Investigators in Japan include the following: Noriya Uedo, Yoji Takeuchi (Osaka Medical Cancer for Cancer and Cardiovascular Diseases, Osaka); Hisashi Doyama, Yoshibumi Kaneko, Kenichi Takemura, Kazuhiro Miwa, Shinya Yamada (Ishikawa Prefectural Central Hospital, Ishikawa); Yutaka Saito, Ichiro Oda, Shigetaka Yoshinaga, Satoru Nonaka, Shusei Fukunaga (National Cancer Center Hospital, Tokyo); Manabu Muto, Yasumasa Ezoe, Shuko Morita, Takahiro Horimatsu (Kyoto University,
References (29)
- et al.
Novel zoom endoscopy technique for diagnosis of small flat gastric cancer: a prospective, blind study
Clin Gastroenterol Hepatol
(2007) - et al.
Magnifying narrow-band imaging versus magnifying white-light imaging for the differential diagnosis of gastric small depressive lesions: a prospective study
Gastrointest Endosc
(2010) - et al.
White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma
Gastrointest Endosc
(2008) - et al.
Magnifying endoscopy with narrow-band imaging achieves superior accuracy in the differential diagnosis of superficial gastric lesions identified with white-light endoscopy: a prospective study
Gastrointest Endosc
(2010) - et al.
Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial
Lancet
(2008) - et al.
Narrow band imaging: a new diagnostic approach to visualize angiogenesis in the superficial neoplasia
Clin Gastroenterol Hepatol
(2005) - et al.
Novel magnified endoscopic findings of microvascular architecture in intramucosal gastric cancer
Gastrointest Endosc
(2002) - et al.
Prospective evaluation of complications in outpatient GI endoscopy: a survey among German gastroenterologists
Gastrointest Endosc
(2001) - et al.
Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008
Int J Cancer
(2010) - et al.
Endoscopic resection of early gastric cancer
Endoscopy
(1993)
Endoscopic mucosal resection for treatment of early gastric cancer
Gut
Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers
Gastric Cancer
Early gastric cancer in Europe
Gut
Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer
Gastric Cancer
Cited by (321)
The Pink Zone Pattern (PP) sign: A novel simple marker for early gastric cancer
2023, Digestive and Liver DiseaseIntensive Systematic “Train-the-Trainer” Course as an Effective Strategy to Improve Detection of Early Gastric Cancer: A Multicenter Retrospective Study
2023, Journal of Gastrointestinal Surgery
Conflicts of interest The authors disclose no conflicts.
Funding Supported by a part of grant-in-aid for cancer research from the Ministry of Health (H21-009), Labor, and Welfare of Japan.