Characteristic findings of high-grade cervical intraepithelial neoplasia or more on magnifying endoscopy with narrow band imaging

  • Kunihisa Uchita
  • Kenji Kanenishi
  • Koki Hirano
  • Hideki Kobara
  • Noriko Nishiyama
  • Ai Kawada
  • Shintaro Fujihara
  • Emi Ibuki
  • Reiji Haba
  • Yohei Takahashi
  • Yuka Kai
  • Kenji Yorita
  • Hirohito Mori
  • Jun Kunikata
  • Naoki Nishimoto
  • Toshiyuki Hata
  • Tsutomu Masaki
Original Article
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Abstract

Background

Colposcopy, which is a standard modality for diagnosing cervical intraepithelial neoplasia (CIN), can have limited accuracy owing to poor visibility. Flexible magnifying endoscopy with narrow band imaging (ME-NBI) has excellent diagnostic accuracy for early gastrointestinal neoplasms and is expected to be highly useful for CIN diagnosis. This study aimed to determine the characteristic findings and evaluate the diagnostic ability of ME-NBI for lesions ≥ CIN 3.

Methods

A well-designed prospective diagnostic case series conducted at multiple tertiary-care centers. A total of 24 patients who underwent cervical conization with a preoperative diagnosis of high-grade squamous cell intraepithelial lesions (HSILs) or lesions ≥ CIN 3 were enrolled. Prior to conization, still images and video of ME-NBI were captured to investigate the cervical lesions. The images were reviewed based on histological examination of the resected specimens.

Results

The NBI-ME images revealed the following abnormal findings: (1) light white epithelium (l-WE), (2) heavy white epithelium (h-WE), and (3) atypical intra-epithelial papillary capillary loop (IPCL). Pathological examination of the resected specimens confirmed cervical lesions ≥ CIN 3 in 21 patients. The ME-NBI findings were classified into four groups: l-WE, l-WE with atypical IPCL, h-WE, and h-WE with atypical IPCL, at rates of 0, 23.8, 9.5, and 66.7%, respectively. Additionally, all 3 patients with micro-invasive carcinoma showed a strong irregularity of IPCLs.

Conclusion

The lesions ≥ CIN 3 demonstrated characteristic ME-NBI findings of h-WE alone, or l-/h-WE with atypical micro-vessels. This study indicates that ME-NBI may have novel value for CIN diagnosis.

Keywords

Cervical intraepithelial neoplasia Magnifying endoscopy with narrow band imaging Diagnostic tool White epithelium 

Notes

Acknowledgments

This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 17K15775.

Compliance with ethical standards

Conflict of interest

No authors have any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Kunihisa Uchita
    • 1
  • Kenji Kanenishi
    • 2
  • Koki Hirano
    • 5
  • Hideki Kobara
    • 3
  • Noriko Nishiyama
    • 3
  • Ai Kawada
    • 1
  • Shintaro Fujihara
    • 3
  • Emi Ibuki
    • 4
  • Reiji Haba
    • 4
  • Yohei Takahashi
    • 5
  • Yuka Kai
    • 5
  • Kenji Yorita
    • 6
  • Hirohito Mori
    • 3
  • Jun Kunikata
    • 7
  • Naoki Nishimoto
    • 7
  • Toshiyuki Hata
    • 2
  • Tsutomu Masaki
    • 3
  1. 1.Department of GastroenterologyKochi Red Cross HospitalKochiJapan
  2. 2.Department of Gynecology, Faculty of MedicineKagawa UniversityKagawaJapan
  3. 3.Department of Gastroenterology and Neurology, Faculty of MedicineKagawa UniversityKagawaJapan
  4. 4.Department of Diagnostic Pathology, Faculty of MedicineKagawa UniversityKagawaJapan
  5. 5.Department of GynecologyKochi Red Cross HospitalKochiJapan
  6. 6.Department of Diagnostic PathologyKochi Red Cross HospitalKochiJapan
  7. 7.Department of Clinical Research Support Center, Faculty of MedicineKagawa UniversityKagawaJapan

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