NOVEL CHROMOENDOSCOPIC METHOD USING AN ACETIC ACID–INDIGOCARMINE MIXTURE FOR DIAGNOSTIC ACCURACY IN DELINEATING THE MARGIN OF EARLY GASTRIC CANCERS

Abstract

Background and Aim: Recent endoscopic imaging techniques for recognition of unclear lesions in the stomach (e.g. narrow band imaging, magnifying endoscopy) require special equipment and therefore are not commonly used. The aim of the present study was to estimate the accuracy of a new chromoendoscopic method using an acetic acid–indigo carmine mixture (AIM) in diagnosing early gastric cancers (EGC). Methods: Studied were 108 EGC lesions in 104 patients. EGC were initially observed by white light (WL) after which indigo carmine (IC) solution was sprinkled onto the gastric mucosa. Images by WL and IC observation were recorded by a digital filing system. After washing away IC solution with water, AIM solution was sprinkled onto the gastric mucosa and images were recorded. Margin lines of EGC determined by each observation were drawn on recorded images by graphic software for comparison with resected specimens. After lines were similarly drawn on images of resected specimens, the extent of the lesions was compared with that determined by endoscopic images. Results: Diagnostic accuracy of WL, IC, and AIM observations were 50.0%, 75.9% and 90.7%, respectively. No adverse events occurred with the AIM method. Conclusions: This chromoendoscopic method can be used to delineate the margin of EGC accurately, easily, safely and inexpensively.