title: Can we accurately diagnose minute gastric cancers (≤5 mm)? Chromoendoscopy (CE) vs magnifying endoscopy with narrow band imaging (M-NBI).
abstract: BACKGROUND
  Chromoendoscopy (CE) is relatively ineffective at identifying the cancer-specific morphological characteristics of minute gastric cancers less than or equal to 5 mm in diameter, and on its own is insufficient to make an accurate diagnosis. The aim of this study is to assess the diagnostic performance of magnifying endoscopy with narrow band imaging (M-NBI) for minute gastric cancers.
  
  
  METHODS
  The minute cancer group comprised consecutive endoscopic submucosal dissection-resected minute gastric cancers histologically measured as no larger than 5 mm in diameter. The non-cancer group comprised consecutive non-cancer lesions no larger than 5 mm in diameter. The two groups were subject to retrospective analysis to evaluate the diagnostic ability (sensitivity, specificity, and diagnostic accuracy) and reproducibility of CE and M-NBI.
  
  
  RESULTS
  The results for CE versus M-NBI were as follows: sensitivity 43.7 % (95 % CI, 26.5-61.0 %) versus 78.0 % (95 % CI, 64.0-92.0 %); specificity 81.6 % (95 % CI, 72.6-90.6 %) versus 92.9 % (95 % CI, 87.0-98.9 %); and diagnostic accuracy 69.9 % (95 % CI, 61.0-78.6 %) versus 88.3 % (95 % CI, 82.0-94.5 %). The sensitivity and diagnostic accuracy were, therefore, significantly higher for M-NBI than for CE. The inter-observer variability was κ = 0.08 for CE and κ = 0.56 for M-NBI, while the intra-observer variability was κ = 0.38 and κ = 0.65, respectively.
  
  
  CONCLUSIONS
  M-NBI has greater sensitivity and reproducibility than CE for the diagnosis of minute gastric cancers.
authors.affiliation: Department of Endoscopy, Fukuoka University Chikushi Hospital, Zokumyoin, Chikushino-shi, Fukuoka, 818-8502, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagahama
authors.forename: K
authors.initials: K
authors.lastname: Uchita
authors.forename: Takao
authors.initials: T
authors.lastname: Kanemitsu
authors.forename: Kozue
authors.initials: K
authors.lastname: Tsurumi
authors.forename: Noritaka
authors.initials: N
authors.lastname: Takatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwashita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
mesh_terms: D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D062048:Narrow Band Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*