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Magnifying Endoscopic Diagnosis for Elevated Early Gastric Cancer and Adenoma Hirobumi Toyoizumi 1 , Hisao Tajiri 1,2 1Department of Endoscopy, The Jikei University School of Medicine, Tokyo 2Department of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo Keyword: 隆起型早期胃癌 , 表面隆起型早期胃癌 , 胃腺腫 , NBI併用拡大内視鏡 pp.853-865
Published Date 2011/5/25
DOI https://doi.org/10.11477/mf.1403102251
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 Elevated early gastric cancers are classified into two categories : type 0-I protruded lesions and type 0IIa superficial elevated lesions. Type 0-I cancers are 3mm or more in height, and type 0-IIa cancers are less than 3mm. Irregularity of fine mucosal structure can be observed in elevated early gastric cancers by using ME-NBI(magnifying endoscopy combined with narrow band imaging). In elevated early gastric cancers, as well as the marginal flat area of an elevated or depressed lesion, a specific microvascular pattern called ISIV(intrastructural irregular vessel)is observed. ISIV is a group of microvessels enclosed in round or papillary fine mucosal structure, which show irregularities such as heterogeneous shape, uneven caliber, and abnormal dilatation.

 Gastric adenoma, a benign neoplastic lesion in the stomach, is often difficult to correctly diagnose in terms of its malignant potential and how it differentiates from cancer. We defined the following lesions as adenoma with malignant potential ; gastric lesions with a pre-ESD pathological diagnosis of adenoma, those with a final pathological diagnosis of ESD specimens, those determined to be gastric cancer or a cancer in adenoma. Analyzing 192 adenomas diagnosed with pre-ESD pathology, predicting factors for‘highly-malignant adenoma'were severe atypia in biopsies, lesions larger 2cm in diameter, depressed type lesions or reddish lesions.


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

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