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Digital Colposcopy for the Diagnosis of Cervical Adenocarcinoma Using a Narrow Band Imaging System
  1. Takuma Fujii, MD, PhD*,
  2. Masaru Nakamura, MD*,
  3. Kaori Kameyama, MD, PhD,
  4. Miyuki Saito, CT*,
  5. Hiroshi Nishio, MD*,
  6. Akiko Ohno, MD*,
  7. Nobumaru Hirao, MD*,
  8. Takashi Iwata, MD*,
  9. Katsumi Tsukazaki, MD* and
  10. Daisuke Aoki, MD*
  1. *Departments of Obstetrics and Gynecology and
  2. Departments of Pathology, Keio University, School of Medicine, Tokyo, Japan.
  1. Address correspondence and reprint requests to Takuma Fujii, MD, PhD, Department of Obstetrics and Gynecology, Keio University, School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan. E-mail: fujiit{at}


Introduction: Although the colposcopic features of cervical glandular disease and cervical adenocarcinoma are not widely well known, unique microvascular patterns are reportedly useful for identifying such diseases. The narrow band imaging (NBI) system used in endoscopy can be used to obtain high-contrast vascular images. Therefore, we examined the utility of NBI colposcopy and compared the results with those of conventional colposcopy.

Methods: Twenty-one patients with adenocarinoma in situ or early invasive adenocarcinomas were examined using digital NBI colposcopy, and the photo records were compared with those of conventional colposcopy. The histological examination and immunohistochemistry with anti-CD31 antibody confirmed the microvascular pattern.

Results: Digital NBI colposcopy depicted the fine vascular texture on the surface of the cervix more clearly than conventional colposcopy. The vascular pattern was depicted in 86% (18/21) of glandular disease cases. The characteristic fine vascular patterns were critical for identifying cervical glandular diseases.

Conclusions: Digital NBI colposcopy was useful for identifying early cervical adenocarcinoma as well as adenocarcinoma in situ. This system yields cervical glandular disease-related colposcopic findings that may be useful for both clinical and educational purposes.

  • Narrow band imaging
  • Colposcopy
  • Cervical cancer
  • Adenocarcinoma

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  • The NBI system was provided by Olympus Medical Systems, Corp, Tokyo, Japan. No additional grant or financial incentives were received from the manufacturer.

  • Funding: None