Ultra-high Magnification Endoscopic Observation of Laterally Spreading Tumors Toyoki Kudo 1 , Shin-ei Kudo 1 , Kunihiko Wakamura 1 , Yuichi Mori 1 , Masashi Misawa 1 , Takemasa Hayashi 1 , Makoto Kutsukawa 1 , Katsuro Ichimasa 1 , Yusaku Sugihara 2 , Tomoyuki Ishigaki 1 , Naoya Toyoshima 1 , Yoshiki Wada 1,3 , Hideyuki Miyachi 1 , Fumio Ishida 1 , Haruhiro Inoue 4 1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan 2Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 3Division of Gastroenterology and Hepatology, Internal Medicine, School of Medicine, Tokyo Medical and Dental University, Tokyo 4Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo Keyword: LST(laterally spreading tumor) , 超拡大内視鏡 , EC像 , 構造異型 , 核異型 pp.1716-1731
Published Date 2014/11/25
DOI https://doi.org/10.11477/mf.1403200052
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 Laterally spreading tumors(LSTs)are distinguishable from other types of colorectal tumorous lesions by their characteristic laterally spreading growth pattern which has a minimum diameter of 10mm. The diagnosis and treatment of LSTs depend on the clinicopathological characteristics of their 4 subtypes. Ultra-high magnification endoscopy(CF-Y0001 ; Olympus)has made it possible to obtain images that are magnified 450 times. This has led to ongoing development of a new type of diagnostic method based not only on the detection of structural atypia from pit patterns but also nuclear abnormalities. The diagnostic accuracy of this method is extremely high with a correct diagnostic rate of 97.1% of neoplastic lesions and non-neoplastic lesions, and that of 96.0% of submucosal invasion. In particular, it is easy to obtain satisfactory images of LSTs as they are flat lesions, in contrast to those of other morphological types. Further studies of LST cases will allow development of increasingly accurate invasion-depth diagnosis methods using endoscopic classification(EC).

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