Authors: Kenichi Mizuno Shinei Kudo Kazuo Ohtsuka Shigeharu Hamatani Yoshiki Wada Haruhiro Inoue Yutaka Aoyagi
Publish Date: 2010/12/28
Volume: 56, Issue: 6, Pages: 1811-1817
Abstract
A total of 22 colorectal lesions 11 tubular adenomas and 11 hyperplasia obtained from 22 patients were studied These lesions were analyzed microscopically on tissue specimens immunostained with CD34 Threedimensional images were reconstructed from serial sections of tubular adenomas hyperplasia and normal mucosaThreedimensional reconstructed images of tubular adenoma and normal mucosa to a depth of less than 150 μm from the mucosal surface showed similar structures to images obtained by NBI magnification Microvessel diameter was significantly larger in tubular adenoma than in normal mucosa P = 0002 and hyperplasia P = 0034 and microvessel area was significantly larger in tubular adenoma than in normal mucosa P 0001 and hyperplasia P 0001 only in the superficial mucosal layer to a depth of less than 150 μmTA was characterized by thicker microvessels and higher volume of microvessels than NM and HP Compared with white light NBI can more accurately depict the characteristics of microvessels because it uses light with short wavelengths thereby contributing to high diagnostic capabilityTo reduce morbidity and mortality from colorectal cancer colonoscopy is considered the method of choice for the detection and removal of colon neoplasms especially adenomatous lesions and early cancers Distinguishing colorectal neoplasms from nonneoplastic lesions is one of the main roles of colonoscopyNarrowband imaging NBI is a newly developed imaging technique that uses special filters to narrow the bandwidth of light 1 NBI systems allow visualization of microvessels and the surface structure of the mucosa NBI in combination with magnifying endoscopy has been reported to be useful for the diagnosis of neoplasms arising in the esophagus stomach and oropharynx 2 3 4 5 Several studies have shown that NBI with magnifying endoscopy NBI magnification is useful for differentiating hyperplastic from neoplastic lesions in the colon Machida and others have reported that NBI is superior to conventional colonoscopy and equivalent to chromoendoscopy for differentiating hyperplastic from neoplastic polyps 6 7 8 9 10 11 12 13 14 15 16 17 18 However the relationship between findings on NBI magnification and the microvessel architecture of colorectal lesions and the reasons why NBI magnification is useful for differentiating hyperplastic from neoplastic polyps remain to be clarifiedIn the present study images obtained by NBI magnification were compared with computeraided 3dimensional reconstructed images Threedimensional visualization of the microvessel network according to the distance from mucosal surface is an effective tool for understanding the depth of microvessels visualized on NBI magnification Next we quantitatively analyzed three vascular variables diameter area number in hyperplasia HP tubular adenoma TA and normal mucosa NM according to the depth from the mucosal surface
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