Quality Assessment of Endoscopic Forceps Biopsy Samples under Magnifying Narrow Band Imaging for Histological Diagnosis of Cervical Intraepithelial Neoplasia: A Feasibility Study
Kunihisa Uchita,
Hideki Kobara,
Kenji Yorita,
Yuriko Shigehisa,
Chihiro Kuroiwa,
Noriko Nishiyama,
Yohei Takahashi,
Yuka Kai,
Jun Kunikata,
Toshio Shimokawa,
Uiko Hanaoka,
Kenji Kanenishi,
Tsutomu Masaki,
Koki Hirano,
Noriya Uedo
Affiliations
Kunihisa Uchita
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Hideki Kobara
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Kenji Yorita
Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Yuriko Shigehisa
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Chihiro Kuroiwa
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Noriko Nishiyama
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Yohei Takahashi
Department of Gynecology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Yuka Kai
Department of Gynecology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Jun Kunikata
Department of Clinical Research Support Center, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Toshio Shimokawa
Department of Clinical Study Support Center, Wakayama Medical University, Wakayama 641-8510, Japan
Uiko Hanaoka
Department of Gynecology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Kenji Kanenishi
Department of Gynecology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Tsutomu Masaki
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Koki Hirano
Department of Gynecology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
Noriya Uedo
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka 541-8567, Japan
The current standard for diagnosing cervical intraepithelial neoplasia (CIN) is colposcopy followed by punch biopsy. We have developed flexible magnifying endoscopy with narrow band imaging (ME-NBI) for the diagnosis of CIN. Here, we investigated the feasibility of targeted endoscopic forceps biopsy (E-Bx) under guidance of ME-NBI for the diagnosis of CIN. We prospectively enrolled 32 consecutive patients with confirmed or suspected high-grade CIN undergoing cervical conization. Next to colposcopy, the same patients underwent ME-NBI just before conization. ME-NBI was performed, and 30 E-Bx samples were taken from lesions suspicious for high-grade CIN and 15 from non-suspicious mucosa. We recalled 82 punch biopsy (P-Bx) specimens taken from lesions suspicious for high-grade CIN under colposcopic examination before enrollment. The proportion of sufficient biopsy samples, which had an entire mucosal layer with subepithelial tissue, for the diagnosis of CIN was evaluated by both methods. Performance of targeted E-Bx for the final diagnosis of at least high-grade CIN was calculated. Seventeen P-Bx specimens were unavailable. The proportion of sufficient samples with E-Bx was 84%, which was similar to that with P-Bx (87%) (p = 0.672). The sensitivity, specificity, and accuracy of ME-NBI using E-Bx was 92%, 81%, and 88%, respectively. In conclusion, ME-NBI-guided E-Bx samples were feasible for histological diagnoses of CIN, and further investigation of its diagnostic accuracy is warranted.
