Dig Dis: The effectiveness and feasibility of magnifying endoscopy combined with blue laser imaging in the diagnosis of gastric tumor demarcation without biopsy confirmation

Accurate diagnosis of the dividing line (DL) of gastric tumors is essential for the complete resection of the tumor through endoscopic submucosal dissection (ESD)
.
Before ESD, it was controversial to diagnose DL in gastric tumors only through endoscopy
.
Recently, a prospective single-center study evaluated the diagnostic accuracy of DL in gastric adenomas and well-differentiated adenocarcinomas using only magnifying endoscopy combined with blue laser imaging (M-BLI) and concurrent use of M-BLI and biopsy to confirm the diagnosis of gastric adenomas and well-differentiated adenocarcinomas.
, The research results have been published in Dig Dis
.

Between July 2015 and December 2016, the study included 96 well-differentiated adenocarcinomas and 32 gastric adenomas
.
A total of 122 lesions with clear DL on M-BLI were randomly assigned to receive only M-BLI (M-BLI group) or M-BLI and biopsy confirmation (M-BLI-BC group).
≈5 mm of non-cancerous tissue for biopsy in 4 directions
.
The main purpose is to determine whether M-BLI without biopsy confirmation has a disadvantage compared with M-BLI with biopsy confirmation in terms of diagnostic accuracy and complete resection
.

The results showed that there were no significant differences between the two groups in terms of gender, median age, skin color, circumference, gross type, diagnosis based on biopsy, and Helicobacter pylori infection
.
The diagnostic accuracy of DL in the M-BLI and M-BLI-BC groups were 100 and 95.
0%, respectively, and the complete resection rate was 100%
.

In summary, the results of this study show that the diagnostic ability of M-BLI is very good in diagnosing the boundary between gastric adenoma and well-differentiated adenocarcinoma
.
For these lesions, DL confirmed by M-BLI does not need to be confirmed by biopsy
.

Original source:

Takahiro Nakano, et al.
, Efficacy and Feasibility of Magnifying Blue Laser Imaging without Biopsy Confirmation for the Diagnosis of the Demarcation of Gastric Tumors: A Randomized Controlled Study .
Dig Dis.
2021;39(2):156-164.
doi: 10.
1159 /000510559.