The Usefulness of Microvascular Findings as Visualized by Magnifying Endoscopy for Determining the Margin of Gastric Cancer of the Differentiated-type Kenshi Yao 1 , Makoto Yorioka 1 , Yasuhiro Takagi 1 1Department of Gastroenterology, Fukuoka University Chikushi Hospital Keyword: 拡大内視鏡 , 早期胃癌 , 微小血管構築 , 境界診断 , 分化型癌 pp.1687-1700
Published Date 2003/11/25
DOI https://doi.org/10.11477/mf.1403100729
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 The preoperative diagnosis of the horizontal extent of an early gastric cancer is essential for carrying out minimal invasive surgery and endoscopic mucosal resection. These days, there is a considerable incidence of differentiated-type gastric cancer presenting an unclear margin, which cannot be identified by ordinary endoscopic technique alone. We reported the characteristic findings concerning the microvascular architecture of early gastric cancer as visualized by magnifying endoscopy. The characteristics of the microvascular architecture in intramucosal gastric cancer, (differentiated-type carcinoma) were an irregular microvascular pattern, the presence of a demarcation line and the disappearance of the regular subepithelial capillary network (SECN) pattern. On the other hand, undifferentiated-type carcinoma presents the disappearance of, or a reduced pattern of the regular SECN. The findings of differentiated-type carcinoma seemed to be specific enough for determining the margin of the carcinoma and for making a differential diagnosis between carcinoma and gastritis in the case of flat reddened lesions. We showed two representative cases in this article. In these cases, the margin of the lesions could be identified successfully by applying magnified endoscopy according to the difference in microvascular architecture between cancerous and non-cancerous mucosa. We are utilizing this technique for preoperative diagnosis to determine the horizontal extent of carcinoma in clinical practice. The margins of all the early gastric cancer of differentiated type became visible after magnification and were successfully identified. The magnified endoscopic technique based on the difference in microvascular architecture and density between cancerous and non-cancerous mucosa could become a new diagnostic system for determining the margins of early gastric cancer.

Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院