title: Usefulness of magnifying endoscopy with narrow-band imaging for determining gastric tumor margin.
abstract: OBJECTIVE
  Magnifying endoscopy with narrow-band imaging (ME-NBI) enhances images of the irregular mucosal structures and microvessels of gastric carcinoma, and could be useful for determining the margin between cancerous and non-cancerous mucosa. We evaluated the usefulness of ME-NBI for determining the tumor margin compared with indigocarmine chromoendoscopy (ICC).
  
  
  METHODS
  The subjects were 110 patients (with 118 lesions) who underwent endoscopic submucosal dissection for gastric tumors. They were randomized into ME-NBI and ICC groups. Marking was carried out by electrocautery with the tip of a high-frequency snare at the tumor margins determined by each observation. The distance from the marking dots to the tumor margin was measured histopathologically in the resected specimens. Marking was diagnosed as accurate if the distance was less than 1 mm.
  
  
  RESULTS
  Of the 118 gastric lesions, 55 were allocated to the ME-NBI group, and 63 to the ICC group. Seventeen lesions in the ME-NBI group and 18 lesions in the ICC group were excluded because the distance from the marking dots to the tumor margin was immeasurable histopathologically. Thirty-eight lesions in the ME-NBI group and 45 lesions in the ICC group were evaluated. The rate of accurate marking of the ME-NBI group was significantly higher than that of the ICC group (97.4% vs 77.8%, respectively; P-value = 0.009).
  
  
  CONCLUSIONS
  Magnifying endoscopy with narrow-band imaging can identify gastric tumor margins more clearly than ICC.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Kiyotoki
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Satake
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fukagawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shirai
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hamabe
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004210:Dissection / Q000379:methods; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery