title: Evaluation of microvascular findings of deeply invasive colorectal cancer by endocytoscopy with narrow-band imaging.
abstract: Background and study aims:Magnifying narrow-band imaging (NBI) is useful for examination of colorectal lesions, and endocytoscopy (EC) allows diagnostic evaluation of structural atypia, nuclear atypia, and vascular structures of colorectal tumors. The aim of this study was to examine surface microvessels in deep invasive colorectal cancer using EC with a new NBI video processor system.Patients and methods:We retrospectively assessed 132 colorectal neoplastic lesions: 81 adenomas, 18 intramucosal cancers, 4 submucosal slightly invasive cancers, and 29 submucosal deep invasive cancers. Detailed vascular findings commonly seen in submucosal deep invasive carcinomas included > 2-fold vasodilatation seen in adenomas, abnormal tortuosity and branching, loss of the micro-network pattern, caliber change in > 2 places in a single blood vessel, and blood vessels not visible in a line because they appear like a string of beads (beaded sign).Results:Univariate analysis revealed 4 vascular findings that were strongly predictive of submucosal deep invasion: vasodilatation (odds ratio [OR] 9.31; 95 % confidence interval [CI] 3.57 - 24.30), loss of the micro-network pattern (OR 61.60; 95 % CI 17.87 - 212.29), caliber change (OR 35.7; 95 % CI 9.16 - 139.14), and the beaded sign (OR 45.90; 95 % CI 5.50 - 382.73).Conclusions:Detailed assessment of ultra-magnified microvessels could improve the diagnostic performance for submucosal deep invasive cancer.
  
  
  BACKGROUND
  UMIN-CTR000014033.
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kataoka
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Wakamura
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Katsuro
authors.initials: K
authors.lastname: Ichimasa
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Atushi
authors.initials: A
authors.lastname: Katagiri
authors.affiliation: Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.affiliation: Digestive Disease Center, Showa University, Koto-Toyosu Hospital, Tokyo, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue