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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(09): E1306-E1314
DOI: 10.1055/a-1499-6638
Original article

Unified magnifying endoscopic classification for esophageal, gastric and colonic lesions: a feasibility pilot study

Haruhiro Inoue
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Mary Raina Angeli Fujiyoshi
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Akiko Toshimori
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yusuke Fujiyoshi
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yuto Shimamura
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Mayo Tanabe
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yohei Nishikawa
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yuichiro Mochizuki
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Takuki Sakaguchi
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Ryusuke Kimura
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Shinya Izawa
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Haruo Ikeda
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Manabu Onimaru
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Naoyuki Uragami
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
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Abstract

Background and study aims Image-enhanced magnifying endoscopy allows optimization of the detection and diagnosis of lesions found in the gastrointestinal tract. Current organ-specific classifications are well-accepted by specialized endoscopists but may pose confusion for general gastroenterologists. To address this, our group proposed the Unified Magnifying Endoscopic Classification (UMEC) which can be applied either in esophagus, stomach, or colon. The aim of this study was to evaluate the diagnostic performance and clinical applicability of UMEC.

Patients and methods A single-center, feasibility pilot study was conducted. Two endoscopists with experience in magnifying narrow band imaging (NBI), blinded to white-light and non-magnifying NBI findings as well as histopathological diagnosis, independently reviewed and diagnosed all images based on UMEC. In brief, UMEC is divided into three categories: non-neoplasia, intramucosal neoplasia, and deep submucosal invasive cancer. The diagnostic performance of UMEC was assessed while using the gold standard histopathology as a reference.

Results A total of 303 gastrointestinal lesions (88 esophageal squamous lesions, 90 gastric lesions, 125 colonic lesions) were assessed. The overall accuracy for both endoscopists in the diagnosis of esophageal squamous cell cancer, gastric cancer, and colorectal cancer were 84.7 %, 89.5 %, and 83.2 %, respectively. The interobserver agreement for each organ, Kappa statistics of 0.51, 0.73, and 0.63, was good.

Conclusions UMEC appears to be a simple and practically acceptable classification, particularly to general gastroenterologists, due to its good diagnostic accuracy, and deserves further evaluation in future studies.



Publication History

Received: 05 October 2020

Accepted: 20 April 2021

Article published online:
16 August 2021

© 2021. The Author (s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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