摘要
BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological findings.METHODS Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l'Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological analyses.RESULTS LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis.
BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological findings.METHODS Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l'Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological analyses.RESULTS LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis.
作者简介
Toshihisa Fujiyoshi,ORCID number:0000-0001-9147-871X;Ryoji Miyahara,ORCID number:0000-0001-7172-4602;Kohei Funasaka,ORCID number:0000-0002-3869-1420;Kazuhiro Furukawa,ORCID number:0000-0003-0980-9095;Tsunaki Sawada,ORCID number:0000-0002-4779-9708;Keiko Maeda,ORCID number:0000-0001-7615-0476;Takeshi Yamamura,ORCID number:0000-0003-4994-016X;Takuya Ishikawa,ORCID number:0000-0001-5814-3555;Eizaburo Ohno,ORCID number:0000-0002-7730-4630;Masanao Nakamura,ORCID number:0000-0002-5444-143X;Hiroki Kawashima,ORCID number:0000-0002-3720-781X;Masato Nakaguro,ORCID number:0000-0001-6987-3043;Masahiro Nakatochi,ORCID number:0000-0002-1838-4837;Corresponding author:Ryoji Miyahara,MD,PhD,Associate Professor,Chief Doctor,Department of Gastroenterology and Hepatology,Nagoya University Graduate School of Medicine,65 Tsurumai-cho,Showa-ku,Nagoya 4668550,Japan.myhr@med.nagoya-u.ac.jp,Telephone:+81-52-7442172,Fax:+81-52-7442180,ORCID number:0000-0001-9639-7425.
