Microvascular Structure in the Esophagus from Endoscopic Findings Haruhiro Inoue 1 , Haruo Ikeda 1 , Chiaki Sato 1 , Hiroki Sato 1 , Manabu Onimaru 1 , Noriko Yamaguchi 1 , Hiroaki Ito 1 , Shin-ei Kudo 1 , Roberta Maselli 1 1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan Keyword: 拡大内視鏡 , 食道 , 表在血管網 , IPCL(上皮乳頭内血管ループ) , SECN(上皮下血管ネットワーク) pp.137-147
Published Date 2014/2/25
DOI https://doi.org/10.11477/mf.1403114064
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 Recent advancement of endoscopic imaging technology(NBI magnifying endoscopy)enables precise observation of superficial vascular structure in the esophagus. Superficial vasculature in the esophagus consists of“submucosal vein”,“branching vein network mainly just above muscularis mucosa”,“oblique running vessel”and“IPCL(intra-epithelial papillary capillary loop)”. Endoscopic findings of these vessels were firstly reported in 1996. Among them, IPCL is positioned at epithelium papilla and demonstrates various figure changes according to increase of tissue atypia. In carcinoma in situ, IPCL shows 4 characteristic figure changes ; dilation, meandering, irregular caliber, and shape variation. Recently, SECN(subepithelial capillary network)was also identified as a tiny capillary network just beneath epithelium. SECN changes closely reflects diffuse invasion(INFc)of cancer tissue. In the squamous cell carcinoma, IPCL demonstrates typical figure changes according to cancer invasion depth and finally destroyed and totally disappeared replaced by new tumor vessels. When talking about cancer invasion depth, abnormal vessel size is most objective findings. Normal IPCL has 7.7μm diameter, and B1(IPCL type V-1)demonstrates 21.9μm in size, and B3(IPCL type VN)shows 67.2μm on average. In this article, this process is precisely reported contrasting with histological findings.

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