Takeshi Yasuda1,2, Nobuaki Yagi1, Tatsushi Omatsu1, Sadanari Hayashi1, Yuki Nakahata1, Yuriko Yasuda1, Akihiro Obora1, Takao Kojima1, Yuji Naito2, Yoshito Itoh2
Surg Endosc. 2020 Jun 16. doi: 10.1007/s00464-020-07706-1. Online ahead of print.
Background and aim: Linked color imaging (LCI) is a novel endoscopy system, which enhances slight differences in mucosal color. However, whether LCI is more useful than other kinds of image-enhanced endoscopy (IEE) in recognizing early gastric cancer remains unclear. This study aimed to evaluate LCI efficacy compared with the indigo carmine contrast method (IC), and blue laser imaging-bright (BLI-brt) in early differentiated-type gastric cancer recognition.
Methods: We retrospectively analyzed early differentiated-type gastric cancer, which were examined by all four imaging techniques (white light imaging, IC, LCI, BLI-brt) at Asahi University Hospital from June 2014 to November 2018. Both subjective evaluation (using ranking score: RS) and objective evaluation (using color difference score: CDS) were adopted to quantify early differentiated-type gastric cancer recognition.
Results: During this period, 87 lesions were enrolled in this study. Both RS and CDS of LCI were significantly higher (p < 0.01) than those of IC and BLI-brt. Both RS and CDS of BLI-brt had no significant difference compared with those of IC. Subgroup analysis revealed that LCI was especially useful in post-Helicobacter pylori eradication patients and flat or depressed lesions compared with IC and BLI-brt.
Conclusions: LCI appears to be more beneficial for the recognition of early differentiated-type gastric cancer in endoscopic screenings than IC and BLI-brt from the middle to distant view.
1 Department of Gastroenterology, Asahi University Hospital, 3-23 Hashimoto, Gifu 500-8523, Japan
2 Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 465 Kawaramachi–Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan