Diagnosis of Undifferentiated Micro Gastric Cancer Using Magnified Endoscopy with Narrow Band Imaging Junko Fujisaki 1 , Kazuhisa Okada 1 , Hideomi Tomita 1 , Noriko Yamamoto 2 , Tomohisa Shimizu 1 , Yusuke Horiuchi 1 , Yasumasa Matsuo 1 , Natsuko Yoshizawa 1 , Masami Omae 1 , Hirotaka Ishikawa 1 , Akiyoshi Ishiyama 1 , Toshiaki Hirasawa 1 , Yorimasa Yamamoto 1 , Tomohiro Tsuchida 1 , Masahiro Igarashi 1 1Department of Gastroenterology, Cancer Institute Hospital of JFCR, Tokyo 2Department of Pathology, Cancer Institute of JFCR, Tokyo Keyword: 微小胃癌 , 小胃癌 , 未分化型早期胃癌 , NBI拡大内視鏡 , ESD pp.857-868
Published Date 2013/5/25
DOI https://doi.org/10.11477/mf.1403113836
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 We carried out a comparative investigation of 45 lesions(from 43 patients)of micro gastric cancer, measuring less than 5mm in diameter, and 54 lesions(from 53 patients)of small gastric cancer among patients with undifferentiated cancer who received ESD(endoscopic submucosal dissection)at this hospital between April 2005 and October 2012, and also comparative evaluation of the NBI(narrow band imaging)magnifying endoscopic images and histopathological findings of the 45 lesions of micro gastric cancer. SM cancer was observed in 2 cases of micro gastric cancer(4.4%), and 7 cases of small gastric cancer(13%). In regard to the histopathological findings, the percentage of sig was higher among the cases of micro gastric cancer(42cases ; 93.3%), with 3cases of por(6.7%), while, among the cases of small gastric cancer, there were 39cases of sig(72.2%)and 15cases of por(27.8%). The macroscopic morphological type among the cases of micro gastric cancer was 0-IIb in 11cases(24.4%)and 0-IIc in 34cases(75.6%), while that among the cases of small gastric cancer was 0-IIb in 4cases(7.4%)and 0-IIc in 50cases(92.6%); thus, the percentage of the 0-IIb type was higher among the patients with micro gastric cancer. In the study of micro gastric cancer, the type showing no apparent abnormal vascular pattern, but only enlargement of the intervening part in magnifying NBI images was classified as the S-type and the type showing abnormality of the vascular pattern was classified as the V-type. Histopathological images were classified into whole-layer, middle-upper layer, upper layer and middle-layer depending on the degree of invasion of the submucosa by the cancer. There were 23cases of the S-type showing enlargement of the intervening part and no abnormal vascular finding and 22cases of the V-type showing abnormality of the vascular pattern. In 17 of the 22cases of the V-type(77.3%), the depth of invasion of the cancer was classified as the whole-layer or middle-upper layer type. As for the S-type, cancer limited to the middle layer was observed in 14 of the 23cases(61%). Online markings of the extent of the lesion were performed for 9 points in 6cases, and 5 out of the 9 points(55.6%)were diagnosed properly.

Copyright © 2013, Igaku-Shoin Ltd. All rights reserved.


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