title: Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions.
abstract: BACKGROUND
  The usefulness of magnifying gastroscopy has been reported in differentiating between benign and malignant gastric mucosal lesions. However, there have been no studies of the usefulness of magnifying endoscopy with narrow-band imaging (M-NBI) in the diagnosis of superficial (non-polypoid) elevated lesions of the stomach. In this study, we investigated the ability of M-NBI to differentiate between cancer and adenoma in superficial elevated lesions of the stomach.
  
  
  METHODS
  We examined 93 consecutive superficial elevated lesions of the stomach. We defined the endoscopic criteria for early cancer as red coloring using conventional white light imaging (C-WLI), and an irregular microvascular pattern with a demarcation line, or irregular microsurface pattern with a demarcation line, using M-NBI. We determined the sensitivity, specificity and accuracy of C-WLI and M-NBI in the diagnosis of these 93 lesions.
  
  
  RESULTS
  The sensitivity, specificity, and accuracy (95 % confidence interval) of C-WLI versus M-NBI were 64 % (52-76 %) versus 95 % (90-100 %), 94 % (86-100 %) versus 88 % (77-99 %), and 74 % (66-83 %) versus 92 % (86-98 %), respectively. Sensitivity and accuracy were significantly higher for M-NBI than C-WLI.
  
  
  CONCLUSIONS
  M-NBI appears to be useful in differentiating between cancerous and adenomatous superficial elevated lesions of the stomach.
authors.affiliation: Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maki
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagahama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Beppu
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisabe
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takaki
authors.forename: Fumihito
authors.initials: F
authors.lastname: Hirai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwashita
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003952:Diagnostic Imaging / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013272:Stomach Diseases / Q000175:diagnosis / Q000473:pathology*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology*