Real-time Optical Diagnosis Of Gastric Cancer With Serosal Invasion Using Magnification Endoscopy And Narrow Band Imaging

ObjectivesIn this study,in order to diagnose the gastric cancer with serosal invasion,Magnification Endoscopy and Narrow Band Imaging(ME-NBI)were used to observe the microvascular phenotypes of the serosal surface in the gastric cancer lesion and the normal gastric wall.Furthermore,its sensitivity,specificity and accuracy could be analyzed by comparing with the pathological diagnosis,and would provide a new method for the diagnosis of gastric cancer with serosal invasion.MethodsA total of 19 patients with gastric cancer who were diagnosed and treated in the gastrointestinal surgery department of Fujian Provincial Hospital from April 1,2019 to December 30,2020 were selected.We used the electronic gastroscope with ME-NBI to take pictures and observe the serosal surface in the gastric cancer lesion and the normal gastric wall about 5cm around the lesion.Observe the microvascular phenotype of the respective serosal surface to make an endoscopic diagnosis.By comparing with the pathological diagnosis,to obtain the sensitivity,specificity and accuracy of this method.ResultsUnder ME-NBI endoscopy,when it had the signals included(1)capillary morphology change(2)capillary diameter increase(3)capillary density increase,it was judged that there was serosal invasion(including invasion of the subserosal tissue and invasion of the serosal layer).It was calculated that the accuracy of ME-NBI in judging the serosal invasion of gastric cancer is 94.7%,the sensitivity was 100%,the specificity was 75%,the positive predictive value was 93.8%,and the negative predictive value was 100%.The accuracy of ME-NBI was 78.9% when the irregular changes of microvessels were used to further distinguish the invasion of the subserosal tissue and invasion of the serosal layer.ConclusionsIn this study,it was found that ME-NBI technology has certain diagnostic value for gastric cancer with serosal invasion.We can use the ME-NBI to obtain information on the changes in the morphology,diameter,and density of microvessels on the serosal surface of gastric cancer lesions to determine the serosal invasion.However,further researches are needed to verify the diagnostic criteria.