Features of early gastric cancer and gastric adenoma by enhanced-magnification endoscopy

Changes to the mucosal surface of early gastric carcinomas and gastric adenomas as viewed by enhanced-magnification endoscopy with acetic acid have not been investigated thoroughly. Using this technology, we investigated the appearance of the gastric surface patterns of neoplastic and surrounding no...

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Veröffentlicht in:Journal of gastroenterology 2006-04, Vol.41 (4), p.332-338
Hauptverfasser: Tanaka, Kyosuke, Toyoda, Hideki, Kadowaki, Shigenori, Kosaka, Ryo, Shiraishi, Taizo, Imoto, Ichiro, Shiku, Hiroshi, Adachi, Yukihiko
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container_end_page 338
container_issue 4
container_start_page 332
container_title Journal of gastroenterology
container_volume 41
creator Tanaka, Kyosuke
Toyoda, Hideki
Kadowaki, Shigenori
Kosaka, Ryo
Shiraishi, Taizo
Imoto, Ichiro
Shiku, Hiroshi
Adachi, Yukihiko
description Changes to the mucosal surface of early gastric carcinomas and gastric adenomas as viewed by enhanced-magnification endoscopy with acetic acid have not been investigated thoroughly. Using this technology, we investigated the appearance of the gastric surface patterns of neoplastic and surrounding nonneoplastic mucosa. Forty-seven consecutive patients with early gastric carcinomas or gastric adenomas underwent enhanced-magnification endoscopy following 1.5% acetic acid instillation. All biopsy specimens were taken from the area at which the enhanced-magnified endoscopic image was obtained. Surface patterns of gastric tumors and the surrounding mucosa were classified into five types: type I, small round pits of uniform size and shape; type II, slit-like pits; type III, gyrus and villous patterns; type IV, irregular arrangements and sizes of pattern types I, II and III; type V, destructive patterns of types I, II and III. The predominant pattern of the surrounding mucosa was type III, and most type III mucosa had characteristics of intestinal metaplasia. Although all elevated adenomas showed type II or type III surface patterns, both depressed adenomas showed type IV. Elevated carcinomas showed type III (42.9%) or type IV (57.1%) surface patterns, while depressed carcinomas showed type IV (70%) or type V (30%). Although differentiated tubular adenocarcinomas showed type III (10.3%), type IV (86.2%), or type V (3.5%) surface patterns, all of the signet-ring cell carcinomas and poorly differentiated tubular adenocarcinomas showed type V. Enhanced-magnification endoscopy may be useful for identifying gastric tumors and determining the extent of horizontal spread, especially in tumors of the depressed type.
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subjects Adenoma - pathology
Biopsy
Carcinoma - pathology
Diagnosis, Differential
Endoscopy, Gastrointestinal - methods
Follow-Up Studies
Humans
Image Enhancement
Neoplasm Staging
Prospective Studies
Stomach Neoplasms - pathology
title Features of early gastric cancer and gastric adenoma by enhanced-magnification endoscopy
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