Diagnosis of Histological Differentiation Using Magnifying Endoscopy Combined with the Narrow Band Imaging System for Early Gastric Cancer Hisao Tajiri 1 , Takashi Nakayoshi 1 , Shoichi Saito 1 , Koji Matsuda 1 , Mitsuru Kaise 1 1Department of Endoscopy, The Jikei University School of Medicine Keyword: 拡大電子内視鏡 , 狭帯域フィルター内視鏡システム , 分化型癌 , 未分化型癌 pp.1701-1708
Published Date 2003/11/25
DOI https://doi.org/10.11477/mf.1403100730
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 We studied the diagnostic possibility for histological differentiation, using magnifying endoscopy combined with the narrow-band imaging(NBI)system for depressed type of early gastric cancer. This system with a magnifying endoscope yielded very clear images of the fine mucosal patterns of the gastric pits and the capillaries on the mucosal surface. The magnifying endoscopic findings for 141 lesions of depressed type of early gastric cancer were compared with the histological findings. The capillaries on the mucosal surface were classified into 2 patterns; a relatively regular fine network pattern and an irregular corkscrew pattern. It was found that 61 of 94 lesions(64.9 %)with differentiated adenocarcinoma showed a relatively regular fine network pattern. On the other hand, 41 of 47 lesions(87.2 %)with undifferentiated adenocarcinoma showed an irregular corkscrew pattern. Mixed lesions of differentiated and undifferentiated adenocarcinoma displayed capillary patterns of both types of cancer. The fine mucosal patterns and the features of capillary vessels, which were identified with the NBI system, correlated well with the histological differentiation. The detailed results produced by this system, and a clear understanding of the characteristics of these results, enable us to improve our ability to differentiate between benign and malignant minute lesions. Additionally, when used in conjunction with conventional endoscopic diagnosis, one is able to more accurately diagnose the extension of cancerous infiltration.

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