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要旨 NBI拡大内視鏡観察でwhite zoneから成る粘膜模様の高度不鮮明化(blurry mucosal pattern ; BMP)と断裂などを伴った網目状血管(irregular mesh pattern ; IMP)をSM 500μm以深浸潤癌(SM群)の画像と仮定し,粘膜内癌またはSM 500μm未満浸潤癌(M群)に比べて有意に高頻度で観察されるか否か114例のESD症例で前向きに検討した.その結果,BMPもIMPも有意にSM群に高頻度に観察された.BMPはM群のうち,粘膜全層を癌が置換した病変にも観察された.IMPは全例tub2癌であり,SM群の画像というよりtub2癌に特有の画像と考えられた.
On the assumption that BMP(blurry mucosal pattern)and IMP(irregular mesh pattern)were NBI-magnifying endoscopic views of submucosal invasion(deeper than 500μm)of gastric cancer, we found that these findings were observed in submucosal cancer(deeper than 500μm)with higher frequency than in mucosal cancer. As a result, both BMP and IMP were observed in submucosal cancer with higher frequency compared to that in mucosal cancer. BMP was also observed in mucosal cancer of which cancer glands existed within entire mucosal layer. The cancer showing IMP belonged to moderate differentiated adenocarcinoma(tub2), so IMP was thought to be specific finding of tub2-cancer.
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