Magnifying Narrow Band Imaging for Determining the Lateral Extent of Helicobacter pylori-Negative Undifferentiated Gastric Cancer Hisashi Doyama 1 , Hiroyoshi Nakanishi 1 , Sho Tsuyama 2 , Naohiro Yoshida 1 , Shinya Yamada 1 , Kenichi Takemura 1 , Ryosuke Ohta 1 , Yasuhito Takeda 1 , Yoshiro Asahina 1 , Kunihiro Tsuji 1 , Kei Tominaga 1 , Satoko Inagaki 1 , Shigetsugu Tsuji 1 , Hideki Niwa 2 , Kazuyoshi Katayanagi 2 , Hiroshi Kurumaya 2 1Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan 2Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan Keyword: Helicobacter pylori , 未分化型胃癌 , 側方進展診断 , NBI , 拡大観察 pp.889-901
Published Date 2014/5/25
DOI https://doi.org/10.11477/mf.1403114178
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 The prevalence of gastric cancer diminishes with an increase in the rate of Helicobacter pylori(HP)infection. However, the risk of gastric cancer remains in patients without HP infection. Histopathologically, undifferentiated gastric cancer is dominant in HP-negative cases. In this study, we retrospectively investigated the diagnostic performance of M-NBI(magnifying narrow band imaging)for determining the lateral extent of HP-negative, undifferentiated gastric cancer. The prevalence of HP-negative cancer was low(15.2%)among all cases of undifferentiated gastric cancers resected by endoscopic submucosal dissection. The diagnostic accuracy of M-NBI in determining the lateral extent of HP-negative, undifferentiated gastric cancer was inadequate and did not differ from that of C-WLI(conventional white light imaging). Therefore, M-NBI did not offer an additional advantage when the tumor margins were not identified by C-WLI. In particular, the lateral extent was difficult to diagnose because of very subtle color differences or because of the presence of developing cancer cells in the intermediate and/or deep mucosal layers as observed by histopathological examination. In cases of undifferentiated gastric cancer, multiple biopsy specimens should be obtained from the surrounding mucosa.

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