Usefulness of Magnifying Endoscopy with Narrow Band Imaging in the Determination of IIb Spreading of Early Gastric Cancer Masaaki Kobayashi 1 , Manabu Takeuchi 2 , Satoru Hashimoto 1 , Akito Sato 1 , Rintaro Narisawa 2 , Yutaka Aoyagi 1 , Yoichi Ajioka 3 1Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, Niigata, Japan 2Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan 3Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan Keyword: NBI拡大内視鏡 , ESD , 早期胃癌 , 範囲診断 , IIb進展 pp.123-131
Published Date 2010/1/25
DOI https://doi.org/10.11477/mf.1403101840
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 We retrospectively analyzed 541 early gastric cancers from patients who underwent endoscopic submucosal dissection(ESD)after detailed observation by magnifying endoscopy with narrow band imaging(ME-NBI). By conventional endoscopy, it was difficult to make a correct determination of IIb spreading of differentiated-type adenocarcinoma with gastric mucin phenotype. The findings of ME-NBI were loop-form microvessels in each small granular structure(Fig. 3, 5). The margin of this lesion could be visualized by the microvascular and fine glandular architecture different from those of the surrounding non-neoplastic mucosa. In IIb spreading of moderately or poorly differentiated-type adenocarcinoma, ME-NBI showed irregular microvessels with disappearance of the fine structure(Fig. 4). Because ME-NBI wasn't able to clarify IIb spreading of two carcinomas : carcinoma with hyperplastic polyp(Fig. 6)and carcinoma with phenotype of complete-type intestinal metaplasia(Fig. 7), we took biopsy specimens to determine the horizontal margin.

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