scholarly journals Diagnosis of Early Gastric Cancer by Magnifying Endoscopy with NBI from Viewpoint of Histological Imaging: Mucosal Patterning in terms of White Zone Visibility and Its Relationship to Histology

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kazuyoshi Yagi ◽  
Yujiro Nozawa ◽  
Shinsaku Endou ◽  
Atsuo Nakamura
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Magnifying Endoscopy ◽  
Gastric Epithelium ◽  
Mucosal Pattern ◽  
White Zone ◽  
Microvascular Pattern

The diagnosis of early gastric cancer by magnifying endoscopy with NBI is based on two components: microvascular pattern and mucosal pattern. Mucosal patterns are characterized by a whitish edge, which has been named the white zone. Some cancerous areas showing a distinct white zone form clear mucosal patterns, whereas others showing a nondistinct white zone do not form mucosal patterns. The aim of the present study was to clarify the histological differences between these two types of area. In transverse sections of gastric epithelium, the lengths of intervening parts in areas showing a distinct white zone, a nondistinct white zone, and an invisible white zone were measured, and the depths of the crypts in these three types of area were also measured. The intervening parts in areas with a nondistinct or invisible white zone were shorter than those in areas with a distinct white zone (), and the crypts in the former areas were shallower than those in the latter (). Areas in which the intervening part were long and the crypts deep tended to show a distinct white zone, whereas areas with short intervening parts or shallow crypts tended to show a nondistinct or non-visible white zone.

scholarly journals Differences in the Microsurface and Microvascular Features between Early Gastric Cancer of Corpus and Antrum under Narrow Band Imaging Magnifying Endoscopy

2019 ◽  
Author(s):  
Qian Zhuang ◽  
Jing Wang ◽  
Shengzheng Luo ◽  
Xiaowan Wu ◽  
Jinnian Cheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Tumor Location ◽  
Magnifying Endoscopy ◽  
Histologic Type ◽  
Invasion Depth ◽  
Macroscopic Shape ◽  
Microvascular Pattern

Abstract Objectives Microsurface structure (MS) and microvascular features (MV) of early gastric cancer (EGC) are associated with the histologic type, invasion depth and macroscopic shape of lesions. However, no studies have reported the differences in the MS and MV features between EGCs of antrum and corpus under magnifying endoscopy with narrow band imaging (ME-NBI).Methods This is a retrospective study including 116 patients with EGC. The characteristics of MS and MV pattern of EGC were evaluated in 2 group, antrum type and corpus type.Results According to the Sakaki’s classification, the MS of EGCs presented as IV, V1 or VI typein in sequence, one level higher than the previous type in the degree of atypia. Tumor location and differentiated degree were identified as independent predictors for MS pattern. For the probability of at least one level higher, in the MS pattern, the corporal EGCs was 5.84 times as high as that of antral EGCs ( χ 2 =9.42, P=0.002, 95%CI 1.89-18.05), and undifferentiated-type lesions was 8.82 times as high as that of the differentiated-type lesions ( χ 2 =11.67, P=0.001, 95%CI 2.53-30.76). No difference in the MV pattern was observed between antral EGCs and corporal EGCs (P=0.7), while the microvascular pattern and microsurface pattern (VS pattern, FNP, ILL-1, ILL-2 and CSP) were significantly different between those 2 groups (P=0.001).Conclusions There are significant differences in the MS and VS pattern of EGC between antrum and corpus types. The antral EGC is less obvious than the corporal EGC, therefore, it is more likely to be missed in clinical gastroscopy.

scholarly journals Differences in the Microsurface and Microvascular Features between Early Gastric Cancer of Corpus and Antrum under Narrow Band Imaging Magnifying Endoscopy

2019 ◽  
Author(s):  
Qian Zhuang ◽  
Jing Wang ◽  
Shengzheng Luo ◽  
Xiaowan Wu ◽  
Jinnian Cheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Tumor Location ◽  
Magnifying Endoscopy ◽  
Histologic Type ◽  
Invasion Depth ◽  
Macroscopic Shape ◽  
Microvascular Pattern

Abstract Background Microsurface structure (MS) and microvascular features (MV) of early gastric cancer (EGC) are associated with the histologic type, invasion depth and macroscopic shape of lesions. However, no studies have reported the differences in the MS and MV features between EGCs of antrum and corpus under magnifying endoscopy with narrow band imaging (ME-NBI).Methods This was a retrospective study including 116 patients with EGC. The characteristics of MS and MV pattern of EGC were evaluated in 2 group, antrum type and corpus type.Results According to the Sakaki’s classification, the MS of EGCs presented as IV, V1 or VI typein in sequence, one level higher than the previous type in the degree of atypia. Tumor location and differentiated degree were identified as independent predictors for MS pattern. For the probability of at least one level higher, in the MS pattern, the corporal EGCs was 5.84 times as high as that of antral EGCs ( χ 2 =9.42, P=0.002, 95%CI 1.89-18.05), and undifferentiated-type lesions was 8.82 times as high as that of the differentiated-type lesions ( χ 2 =11.67, P=0.001, 95%CI 2.53-30.76). No difference in the MV pattern was observed between antral EGCs and corporal EGCs (P=0.7), while the microvascular pattern and microsurface pattern (VS pattern, FNP, ILL-1, ILL-2 and CSP) were significantly different between those 2 groups (P=0.001).Conclusions There are significant differences in the MS and VS pattern of EGC between antrum and corpus types. The antral EGC is less obvious than the corporal EGC, therefore, it is more likely to be missed in clinical gastroscopy.

Endoscopic submucosal dissection by using Clutch cutter and IT knife 2 for early gastric cancer with severe submucosal fibrosis: a case report

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 17-21
Author(s):  
Nhan Le ◽  
Phuong Vien ◽  
Nghia Le
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastrointestinal Cancers ◽  
Pathological Result ◽  
Well Differentiated ◽  
Submucosal Fibrosis

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis. Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence. Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

Comparison of Four Methods Using Magnifying Endoscopy for Recognition of the Demarcation in Early Gastric Cancer

2008 ◽  
Vol 67 (5) ◽  
pp. AB134
Author(s):  
Kyosuke Tanaka ◽  
Hideki Toyoda ◽  
Yasuhiko Hamada ◽  
Masaki Katsurahara ◽  
Hiroyuki Inoue ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Magnifying Endoscopy
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