Endoscopy 2020; 52(S 01): S63
DOI: 10.1055/s-0040-1704198
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 16:30 – 18:00 Improving outcomes in Wicklow Meeting Room 3GI- endoscopy
© Georg Thieme Verlag KG Stuttgart · New York

USEFULNESS OF NARROW-BAND IMAGING WITH NEAR-FOCUS MAGNIFICATION FOR DISCRIMINATING THE GASTRIC TUMOR MARGIN BEFORE ENDOSCOPIC RESECTION: A PROSPECTIVE RANDOMIZED MULTICENTER TRIAL

Research Group for Endoscopic Instruments and Stents of Korean Society of Gastrointestinal Endoscopy
JY Jang
1   College of Medicine, Kyung Hee University, Internal Medicine, Seoul, Korea, Republic of
,
JW Kim
1   College of Medicine, Kyung Hee University, Internal Medicine, Seoul, Korea, Republic of
,
Y Jung
2   Soon Chun Hyang University College of Medicine, Internal Medicine, Cheonan, Korea, Republic of
,
GH Kim
3   Pusan National University School of Medicine, Internal Medicine, Busan, Korea, Republic of
,
BW Bang
4   Inha University Hospital, Inha University School of Medicine, Internal Medicine, Incheon, Korea, Republic of
,
JC Park
5   Severance Hospital, Yonsei University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
,
HS Choi
6   Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
,
JH Cho
7   Digestive Disease Center, Soon Chun Hyang University, Seoul, Korea, Republic of
,
YW Chang
1   College of Medicine, Kyung Hee University, Internal Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims This prospective randomized multicenter study investigated the usefulness of near focus with narrow-band imaging (NF-NBI) for determining gastric tumor margins compared with indigo carmine chromoendoscopy (ICC) before endoscopic submucosal dissection (ESD).

    Methods Patients with gastric adenoma or differentiated adenocarcinoma undergoing ESD were enrolled and randomly assigned to the NF-NBI or ICC group. A point on the margin on the most proximal side of the lesion was marked after inspection. Tumor delineation was considered accurate when the marking dots were located within 1 mm of the tumor margin under microscopic observation.

    Results Finally, 200 patients in the NF-NBI group and 195 patients in the ICC group were included. No significant differences were observed in clinicopathological characteristics between the two groups. The distance from the marking dot to the margin of the tumor was significantly shorter in the NF-NBI group than in the ICC group (0.8 ± 0.8 mm vs. 1.2 ± 1.3 mm, p < 0.01). The delineation accuracy rate was 84.5% in the NF-NBI group and 81.0% in the ICC group (p = 0.44). Although NF-NBI and other clinicopathological factors were not significantly associated with accurate delineation, carcinoma in the NF-NBI group was a significant predictive factor (odds ratio, 3.55, 95% confidence interval: 1.42-8.85, p = 0.03).

    Conclusions This prospective multicenter study showed that NF-NBI is not superior to ICC in terms of accurately delineating gastric tumors. However, the results suggest a potential benefit of NF-NBI for tumor delineation as an alternative to ICC.


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