Endoscopy 2015; 47(01): 19-25
DOI: 10.1055/s-0034-1377965
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endocytoscopy is a promising modality with high diagnostic accuracy for gastric cancer

Mitsuru Kaise
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Yasuo Ohkura
2  Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
,
Toshiro Iizuka
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Ryusuke Kimura
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Kosuke Nomura
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Yasutaka Kuribayashi
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Akihiro Yamada
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Satoshi Yamashita
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Tsukasa Furuhata
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Daisuke Kikuchi
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Osamu Ogawa
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Akira Matsui
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Toshifumi Mitani
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Shu Hoteya
1  Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 25 December 2013

accepted after revision 07 July 2014

Publication Date:
15 September 2014 (online)

Background and study aim: Endocytoscopy (ECS) enables in vivo microscopic imaging, which allows analysis of mucosal structures at the cellular level; however, limited data are available on the validity of ECS in the stomach. The aim of this study was to evaluate the feasibility of ECS in the diagnosis of early gastric cancer.

Patients and methods: Gastric lesions that were the targets of histopathological diagnosis by endoscopic submucosal dissection or biopsy specimen were prospectively enrolled and evaluated using a single charge-coupled device-integrated endocytoscope, following double staining with crystal violet and methylene blue. High grade ECS atypia was defined according to specific irregularities in gland structure and cell nuclei. The primary end point was the accuracy of ECS diagnosis for gastric cancer, using histopathological diagnosis as the gold standard.

Results: A total of 82 lesions were investigated, including 23 early gastric cancers, 10 gastric adenomas, and 49 non-neoplastic lesions. Ten lesions could not be clearly observed by ECS because of poor staining due to viscous mucus or plaque; thus, assessability rates with ECS were 88 % in total and 91 % for gastric cancer. High grade ECS atypia was observed in 86 % of assessable gastric cancers, but not in any cases of gastric adenomas or non-neoplastic lesions. The sensitivity, specificity, positive and negative predictive values of high grade ECS atypia as the criterion for the diagnosis of gastric cancer were 86 %, 100 %, 100 %, and 94 %, respectively. No serious complications occurred during or after the examinations.

Conclusion: ECS is a clinically feasible modality to obtain in vivo histology, with high diagnostic accuracy in gastric cancer.