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| 1 | Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy显示文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed. | Chonlada Krutsri Mitsuhiro Kida Hiroshi Yamauchi Tomohisa Iwai Hiroshi Imaizumi Wasaburo Koizumi | 2019 | World Journal of Gastroenterology2019，25，26： | 23 |
| 2 | Systematic review comparing endoscopic, percutaneous and surgical pancreatic pseudocyst drainage显示文摘AIM: To perform a systematic review comparing the outcomes of endoscopic, percutaneous and surgical pancreatic pseudocyst drainage.METHODS: Comparative studies published between January 1980 and May 2014 were identified on Pub Med, Embase and the Cochrane controlled trials register and assessed for suitability of inclusion. The primary outcome was the treatment success rate. Secondary outcomes included were the recurrence rates, re-interventions, length of hospital stay, adverse events and mortalities.RESULTS: Ten comparative studies were identified and 3 were randomized controlled trials. Four studies reported on the outcomes of percutaneous and surgical drainage. Based on a large-scale national study, surgical drainage appeared to reduce mortality and adverse events rate as compared to the percutaneous approach. Three studies reported on the outcomes of endoscopic ultrasound(EUS) and surgical drainage. Clinical success and adverse events rates appeared to be comparable but the EUS approach reduced hospital stay, cost and improved quality of life. Three other studies comparedEUS and esophagogastroduodenoscopy-guided drainage. Both approaches were feasible for pseudocyst drainage but the success rate of the EUS approach was better for non-bulging cyst and the approach conferred additional safety benefits.CONCLUSION: In patients with unfavorable anatomy, surgical cystojejunostomy or percutaneous drainage could be considered. Large randomized studies with current definitions of pseudocysts and longer-term follow-up are needed to assess the efficacy of the various modalities. | Anthony Yuen Bun Teoh Vinay Dhir Zhen-Dong Jin Mitsuhiro Kida Dong Wan Seo Khek Yu Ho | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，6： | 13 |
| 3 | Short-type single balloon enteroscope for endoscopic retrograde cholangiopancreatography with altered gastrointestinal anatomy显示文摘AIM:To evaluate the effectiveness of a short-type single-balloon-enteroscope(SBE) for endoscopic retrograde cholangiopancreatography(ERCP) in patients with a reconstructed intestine.METHODS:Short-type SBE was developed to perform ERCP in postoperative patients with a reconstructed intestine.Short-type SBE is a direct-viewing endoscope with the following specifications:working length,1520 mm;total length,1840 mm;channel diameter,3.2 mm.In addition,short-type SBE has a water-jet channel.The study group comprised 22 patients who underwent 31 sessions of short-type SBE-assisted ERCP from June 2011 through May 2012.Reconstruction was performed by Billroth-Ⅱ(B-Ⅱ) gastrectomy in 6 patients(8 sessions),Roux-en-Y(R-Y) gastrectomy in 14 patients(21 sessions),and R-Y hepaticojejunostomy in 2 patients(2 sessions).We retrospectively studied the rate of reaching the blind end(papilla of Vater or choledochojejunal anastomosis),mean time required to reach the blind end,diagnostic success rate(defined as the rate of successfully imaging the bile and pancreatic ducts),therapeutic success rate(defined as the rate of successfully completing endoscopic treatment),mean procedure time,and complications.RESULTS:Among the 31 sessions of ERCP,the rate of reaching the blind end was 88% in B-Ⅱ gastrectomy,91% in R-Y gastrectomy,and 100% in R-Y hepaticojejunostomy.The mean time required to reach the papilla was 18.3 min in B-Ⅱ gastrectomy,21.1 min in R-Y gastrectomy,and 32.5 min in R-Y hepaticojejunostomy.The diagnostic success rates in all patients and those with an intact papilla were respectively 86% and 86% in B-Ⅱ gastrectomy,90% and 87% in R-Y gastrectomy,and 100% in R-Y hepaticojejunostomy.The therapeutic success rates in all patients and those with an intact papilla were respectively 100% and 100% in B-Ⅱ gastrectomy,94% and 92% in R-Y gastrectomy,and 100% in R-Y hepaticojejunostomy.Because the channel diameter was 3.2 mm,stone extraction could be performed with a wire-guided basket in 12 sessions,and wireguided intraductal ultrasonography could be performed in 8 sessions.As for complications,hyperamylasemia(defined as a rise in serum amylase levels to more than 3 times the upper limit of normal) occurred in 1 patient(7 sessions) with a B-Ⅱ gastrectomy and 4 patients(19 sessions) with an R-Y gastrectomy.After ERCP in patients with an R-Y gastrectomy,2 patients(19 sessions) had pancreatitis,1 patient(21 sessions) had gastrointestinal perforation,and 1 patient(19 sessions) had papillary bleeding.Pancreatitis and bleeding were both mild.Gastrointestinal perforation improved after conservative treatment.CONCLUSION:Short-type SBE is effective for ERCP in patients with a reconstructed intestine and allows most conventional ERCP devices to be used. | Hiroshi Yamauchi Mitsuhiro Kida Kosuke Okuwaki Shiro Miyazawa Tomohisa Iwai Miyoko Takezawa Hidehiko Kikuchi Maya Watanabe Hiroshi Imaizumi Wasaburo Koizumi | 2013 | World Journal of Gastroenterology2013，19，11： | 10 |
| 4 | Innovations and techniques for balloon-enteroscopeassisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy显示文摘Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy. | Hiroshi Yamauchi Mitsuhiro Kida Hiroshi Imaizumi Kosuke Okuwaki Shiro Miyazawa Tomohisa Iwai Wasaburo Koizumi | 2015 | World Journal of Gastroenterology2015，21，21： | 9 |
| 5 | Biliary tuberculosis causing cicatricial stenosis after oral anti-tuberculosis therapy显示文摘与黑暗的尿和黄巩膜介绍的一个 36 岁的菲律宾的女人。内视镜后退 cholangiopancreatography (ERCP ) 证实了肝内胆汁管的膨胀并且也在肝核显示出普通的肝的管的不规则的苛评。从胆汁管的活体检视的组织学的检查揭示了上皮状的房间风湿性肉芽肿和干酪样坏死。小块茎杆菌然后在胆汁测试的聚合酶链反应(PCR ) 上被检测,给胆汁的肺结核的诊断。尽管微生物痊愈被证实,病人开发了肝的管的 cicatricial。她与内视镜的胆汁的排水(EBD ) 经历了重复治疗试管和经皮的 transhepatic 胆汁的排水(PTBD ) 试管,和狭窄在 6 年以后被改正。我们在场有结节的胆汁的苛评的一个盒子,从更普通的恶意要求小心的区别并且由于处理以后的 cicatricial 的风险需要长期的后续的一个条件,尽管它是稀罕的。 | Tomohisa Iwai Mitsuhiro Kida Yoshiki Kida Nobuaki Shikama Akitaka Shibuya Katsunori Saigenji | 2006 | World Journal of Gastroenterology2006，12，30： | 6 |
| 6 | Safety and efficacy of metallic stent for unresectable distal malignant biliary obstruction in elderly patients显示文摘AIM To study the safety of insertion of metallic stents in elderly patients with unresectable distal malignant biliary obstruction.METHODS Of 272 patients with unresectable distal malignant biliary obstruction, 184 patients under the age of 80 were classified into Group A, and 88 subjects aged 80 years or more were classified into Group B. The safety of metallic stent insertion, metal stent patency period, and the obstruction rate were examined in each group.RESULTS In Group B, patients had a significantly worse per-formance status, high blood pressure, heart disease, cerebrovascular disease, and dementia; besides the rate of patients orally administered antiplatelet drugs or anticoagulants tended to be higher(P < 0.05). Metallic stents were successfully inserted in all patients. The median patency period was 265.000 ± 26.779(1-965) d; 252.000 ± 35.998(1-618) d in Group A and 269.000 ± 47.885(1-965) d in Group B, with no significant difference between the two groups. Metallic stent obstruction occurred in 82 of the 272(30.15%) patients; in 53/184(28.80%) patients in Group A and in 29/88(32.95%) of those in Group B, showing no significant difference between the two groups. Procedural accidents due to metal stent insertion occurred in 24/272(8.8%) patients; in 17/184(9.2%) of patients in Group A and in 7/88(8.0%) of those in Group B, with no significant difference between the two groups, either.CONCLUSION These results suggested that metallic stents can be safely inserted to treat unresectable distal malignant biliary obstruction even in elderly patients aged 80 years or more. | Yuji Sakai Tomohisa Iwai Kenji Shimura Katsushige Gon Kazuya Koizumi Masashi Ijima Kazuro Chiba Seigo Nakatani Harutoshi Sugiyama Toshio Tsuyuguchi Terumi Kamisawa Iruu Maetani Mitsuhiro Kida | 2018 | World Journal of Gastroenterology2018，24，1： | 4 |
| 7 | First case of IgG4-related sclerosing cholangitis associated with autoimmune hemolytic anemia显示文摘To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pancreatitis(AIP)and respond to steroid treatment.However,isolated cases of IgG4-SC are difficult to diagnose.We describe our experience with a patient who had IgG4-SC without AIP in whom the presence of AIHA led to diagnosis.The patient was a73-year-old man who was being treated for dementia.Liver dysfunction was diagnosed on blood tests at another hospital.Imaging studies suggested the presence of carcinoma of the hepatic hilus and primary sclerosing cholangitis,but a rapidly progressing anemia developed simultaneously.After the diagnosis of AIHA,steroid treatment was begun,and the biliary stricture improved.IgG4-SC without AIP was thus diagnosed. | Hironori Masutani Kosuke Okuwaki Mitsuhiro Kida Hiroshi Yamauchi Hiroshi Imaizumi Shiro Miyazawa Tomohisa Iwai Miyoko Takezawa Wasaburo Koizumi | 2014 | World Journal of Gastroenterology2014，20，26： | 3 |
| 8 | Usefulness of serum lipase for early diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis显示文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)is new onset acute pancreatitis after ERCP.This complication is sometimes fatal.As such,PEP should be diagnosed early so that therapeutic interventions can be carried out.Serum lipase(s-Lip)is useful for diagnosing acute pancreatitis.However,its usefulness for diagnosing PEP has not been sufficiently investigated.AIM This study aimed to retrospectively examine the usefulness of s-Lip for the early diagnosis of PEP.METHODS We retrospectively examined 4192 patients who underwent ERCP at our two hospitals over the last 5 years.The primary outcomes were a comparison of the areas under the receiver operating characteristic(ROC)curves(AUCs)of s-Lip and serum amylase(s-Amy),s-Lip and s-Amy cutoff values based on the presence or absence of PEP in the early stage after ERCP via ROC curves,and the diagnostic properties[sensitivities,specificities,positive predictive values(PPV),and negative predictive value(NPV)]of these cutoff values for PEP diagnosis.RESULTS Based on the eligibility and exclusion criteria,804 cases were registered.Over the entire course,PEP occurred in 78 patients(9.7%).It occurred in the early stage after ERCP in 40 patients(51.3%)and in the late stage after ERCP in 38 patients(48.7%).The AUCs were 0.908 for s-Lip[95%confidence interval(CI):0.880-0.940,P<0.001]and 0.880 for s-Amy(95%CI:0.846-0.915,P<0.001),indicating both are useful for early diagnosis.By comparing the AUCs,s-Lip was found to be significantly more useful for the early diagnosis of PEP than s-Amy(P=0.023).The optimal cutoff values calculated from the ROC curves were 342 U/L for s-Lip(sensitivity,0.859;specificity,0.867;PPV,0.405;NPV,0.981)and 171 U/L for s-Amy(sensitivity,0.859;specificity,0.763;PPV,0.277;NPV,0.979).CONCLUSION S-Lip was significantly more useful for the early diagnosis of PEP.Measuring s-Lip after ERCP could help diagnose PEP earlier;hence,therapeutic interventions can be provided earlier. | Masayoshi Tadehara Kosuke Okuwaki Hiroshi Imaizumi Mitsuhiro Kida Tomohisa Iwai Hiroshi Yamauchi Toru Kaneko Rikiya Hasegawa Eiji Miyata Yusuke Kawaguchi Hironori Masutani Wasaburo Koizumi | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，9： | 3 |
| 9 | Clinical implications of doubling time of gastrointestinal submucosal tumors显示文摘AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such tumors.RESULTS The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection. | Shuko Koizumi Mitsuhiro Kida Hiroshi Yamauchi Kosuke Okuwaki Tomohisa Iwai Shiro Miyazawa Miyoko Takezawa Hiroshi Imaizumi Wasaburo Koizumi | 2016 | World Journal of Gastroenterology2016，22，45： | 3 |
| 10 | Passive-bending,short-type single-balloon enteroscope for endoscopic retrograde cholangiopancreatography in Roux-en-Y anastomosis patients显示文摘AIM:To evaluate short-type-single-balloon enteroscope(SBE) with passive-bending,high-force transmission functions for endoscopic retrograde cholangiopancreatography(ERCP) in patients with Roux-en-Y anastomosis.METHODS:Short-type SBE with this technology(SIF-Y0004-V01; working length,1520 mm; channel diameter,3.2 mm) was used to perform 50 ERCP procedures in 37 patients with Roux-en-Y anastomosis.The rate of reaching the blind end,time required to reach the blind end,diagnostic and therapeutic success rates,and procedure time and complications were studied retrospectively and compared with the results of 34 sessions of ERCP performed using a short-type SBE without this technology(SIF-Y0004; working length,1520 mm; channel diameter,3.2 mm) in 25 patients.RESULTS:The rate of reaching the blind end was 90% with SIF-Y0004-V01 and 91% with SIF-Y0004(P = 0.59).The median time required to reach the papilla was significantly shorter with SIF-Y0004-V01 than with SIF-Y0004(16 min vs 24 min,P = 0.04).The diagnostic success rate was 93% with SIFY0004-V01 and 84% with SIF-Y0004(P = 0.17).The therapeutic success rate was 95% with SIF-Y0004-V01 and 96% with SIF-Y0004(P = 0.68).The median procedure time was 40 min with SIF-Y0004-V01 and 36 min with SIF-Y0004(P = 0.50).The incidence of hyperamylasemia was 6.0% in the SIF-Y0004-V01 group and 14.7% in the SIF-Y0004 group(P = 0.723).The incidence of pancreatitis was 0% in the SIFY0004-V01 group and 5.9% in the SIF-Y0004 group(P > 0.999).The incidence of gastrointestinal perforation was 2.0%(1/50) in the SIF-Y0004-V01 group and 2.9%(1/34) in the SIF-Y0004 group(P > 0.999).CONCLUSION:SIF-Y0004-V01 is useful for ERCP inpatients with Roux-en-Y anastomosis and may reduce the time required to reach the blind end. | Hiroshi Yamauchi Mitsuhiro Kida Kosuke Okuwaki Shiro Miyazawa Tomohisa Iwai Shuko Tokunaga Miyoko Takezawa Hiroshi Imaizumi Wasaburo Koizumi | 2015 | World Journal of Gastroenterology2015，21，5： | 3 |
| 11 | Endosonographic features of esophageal granular cell tumors using a high-frequency catheter probe显示文摘 | Dong Uk Kim Gwang Ha Kim Dong Yup Ryu Dong Gun Lee Jae Hoon Cheong Bong Eun Lee Geun Am Song Do Youn Park Na Ri Shin Hoseok I Mitsuhiro Kida | 2011 | Scandinavian Journal of Gastroenterology2011，，2： | 1 |
| 12 | Vulnerable Sites and Changes in Mucin in the Rat Small Intestine After Non-steroidal Anti-inflammatory Drugs Administration显示文摘 | Tomohisa Iwai Takafumi Ichikawa Mitsuhiro Kida Yukinobu Goso Yoichi Saegusa Isao Okayasu Katsunori Saigenji Kazuhiko Ishihara | 2010 | Digestive Diseases and Sciences2010，，： | 1 |
| 13 | Usefulness of endoscopic aspiration mucosectomy as compared with strip biopsy for the treatment of gastric mucosal cancer显示文摘 | Satoshi Tanabe Wasaburo Koizumi Mikio Kokutou Hiroshi Imaizumi Keita Ishii Mitsuhiro Kida Yasushi Yokoyama Masahito Ohida Katsunori Saigenji Hitoshi Shimao Hiroyuki Mitomi | 1999 | Gastrointestinal Endoscopy1999，，6： | 1 |
| 14 | Phase Ⅰ trial of combination chemotherapy with gemcitabine, cisplatin, and S-1 in patients with advanced biliary tract cancer显示文摘AIM: To evaluate the dose-limiting toxicities(DLTs)and determine the maximum-tolerated dose(MTD) and recommended dose(RD) of combination chemotherapy with gemcitabine, cisplatin and S-1 which is an oral fluoropyrimidine pro-drug in patients with advanced biliary tract cancer.METHODS: Patients with histologically or cytologically confirmed unresectable or recurrent biliary tract cancer were enrolled. The planned dose levels of gemcitabine(mg/m2), cisplatin(mg/m2), and S-1(mg/m2 per day) were as follows: level-1, 800/20/60;level 0, 800/25/60; level 1, 1000/25/60; and level 2,1000/25/80. In each cycle, gemcitabine and cisplatin were administered intravenously on days 1 and 15,and S-1 was administered orally twice daily on days 1to 7 and days 15 to 21, every 4 wk.RESULTS: Twelve patients were enrolled, and level0 was chosen as the starting dose. None of the first three patients had DLTs at level 0, and the dose was escalated to level 1. One of six patients had DLTs(grade 4 febrile neutropenia, leucopenia, and neutropenia; grade 3 thrombocytopenia) at level 1.We then proceeded to level 2. None of three patients had DLTs during the first cycle. Although the MTD was not determined, level 2 was designated at the RD for a subsequent phase Ⅱ study.CONCLUSION: The RD was defined as gemcitabine1000 mg/m2(days 1, 15), cisplatin 25 mg/m2(days1, 15), and S-1 80 mg/m2 per day(days 1-7, 15-21),every 4 weeks. A phase Ⅱ study is planned to evaluate the effectiveness of combination chemotherapy withgemcitabine, cisplatin, and S-1 in advanced biliary tract cancer. | Akinori Watanabe Mitsuhiro Kida Shiro Miyazawa Tomohisa Iwai Kosuke Okuwaki Toru Kaneko Hiroshi Yamauchi Miyoko Takezawa Hiroshi Imaizumi Wasaburo Koizumi | 2015 | World Journal of Gastroenterology2015，21，19： | 1 |
| 15 | Short‐type and conventional single‐balloon enteroscopes for endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: S ingle‐center experience显示文摘 | Tomohisa Iwai Mitsuhiro Kida Hiroshi Yamauchi Hiroshi Imaizumi Wasaburo Koizumi | 2014 | Digestive Endoscopy2014，，： | 1 |
| 16 | Diagnostic performance of endoscopic classifications for neoplastic lesions in patients with ulcerative colitis:A retrospective casecontrol study显示文摘BACKGROUND It is unclear whether the Japan Narrow-Band Imaging Expert Team(JNET)classification and pit pattern classification are applicable for diagnosing neoplastic lesions in patients with ulcerative colitis(UC).AIM To clarify the diagnostic performance of these classifications for neoplastic lesions in patients with UC.METHODS This study was conducted as a single-center,retrospective case-control study.Twenty-one lesions in 19 patients with UC-associated neoplasms(UCAN)and 23 lesions in 22 UC patients with sporadic neoplasms(SN),evaluated by magnifying image-enhanced endoscopy,were retrospectively and separately assessed by six endoscopists(three experts,three non-experts),using the JNET and pit pattern classifications.The results were compared with the pathological diagnoses to evaluate the diagnostic performance.Inter-and intra-observer agreements were calculated.RESULTS In this study,JNET type 2 A and pit pattern typeⅢ/Ⅳwere used as indicators of low-grade dysplasia,JNET type 2 B and pit pattern typeⅥlow irregularity were used as indicators of highgrade dysplasia to shallow submucosal invasive carcinoma,JNET type 3 and pit pattern typeⅥhigh irregularity/VN were used as indicators of deep submucosal invasive carcinoma.In the UCAN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a low positive predictive value(PPV;50.0%and 40.0%,respectively);however,they had a high negative predictive value(NPV;94.7%and 100%,respectively).Conversely,in the SN group,JNET type 2 A and pit pattern typeⅢ/Ⅳhad a high PPV(100%for both)but a low NPV(63.6%and 77.8%,respectively).In both groups,JNET type 3 and pit pattern typeⅥ-high irregularity/VN showed high specificity.The interobserver agreement of JNET classification and pit pattern classification for UCAN among experts were 0.401 and 0.364,in the same manner for SN,0.666 and 0.597,respectively.The intra-observer agreements of JNET classification and pit pattern classification for UCAN among experts were 0.387,0.454,for SN,0.803 and 0.567,respectively.CONCLUSION The accuracy of endoscopic diagnosis using both classifications was lower for UCAN than for SN.Endoscopic diagnosis of UCAN tended to be underestimated compared with the pathological results. | Yuichi Kida Takeshi Yamamura Keiko Maeda Tsunaki Sawada Eri Ishikawa Yasuyuki Mizutani Naomi Kakushima Kazuhiro Furukawa Takuya Ishikawa Eizaburo Ohno Hiroki Kawashima Masanao Nakamura Masatoshi Ishigami Mitsuhiro Fujishiro | 2022 | World Journal of Gastroenterology2022，28，10： | 0 |
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