PURPOSE: NBI (Narrow Band Imaging) is a new optical image enhancement technology used for highlighting blood vessels on mucosal surface and/or fine mucosal patterns by changing the spectral features of light used for endoscopic observation. High magnification bronchoscopy enables an improved observation of subepithelial vascular patterns of the bronchial mucosa. It is reported that the high magnification observation combined with NBI reveals more subtle change or proliferation of intraepithelial capillary vessels in patients with an early stage of hypopharyngeal cancer or esophageal cancer.
METHODS: We performed the high magnification bronchoscopy (XBF-D240HM, Olympus) combined with NBI for bronchial lesions in 25 patients with centrally located lesions (squamous dysplasia 2, lung cancer 20, sarcoidosis 3,). We compared the images from these lesions with normal area in each patient.
RESULTS: In patients with sarcoidosis, we observed slightly hyper vascular epithelia, but they were composed with relatively straight vessels. We could observe fine vessels locating in a surface mucosa represented as brownish light-dark and deeper vessels as cyan-color. NBI visualized more accurately fine surface vessels. In patients with lung cancer, NBI revealed extremely increased hyper vascular lesions, in which many tortuous vessels in superficial mucosa composed a complicated network. These vessels seemed to be different from benign disease and they were potentially indicating the stasis caused by lung cancer.
CONCLUSION: High magnification bronchoscopy combined with NBI was useful for detecting surface epithelial vessels in detail.
CLINICAL IMPLICATIONS: High magnification bronchoscopy combined with NBI may contribute to discriminate an angiogenesis accompanied with carcinogenesis of squamous cell carcinoma.
DISCLOSURE: Yuka Miyazu, None.