Stomach and Intestine(Tokyo) Volume 50, Issue 3 (March 2015)

Characteristic Findings of Difficult Cases to Diagnose Using ME-NBI Junko Fujisaki 1 , Yusuke Horiuchi 1 , Noriko Yamamoto 2 , Hiroki Ohsumi 1 , Yuji Muramatsu 1 , Yuji Miyamoto 1 , Hideomi Tomita 1 , Tomoka Taniguchi 1 , Dai Inoue 1 , Tomoki Shimizu 1 , Masami Omae 1 , Akiyoshi Ishiyama 1 , Toshiyuki Yoshio 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: 早期胃癌 , NBI併用拡大内視鏡 , 中分化型腺癌 , 未分化型腺癌 pp.279-288
Published Date 2015/3/25
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 (1)We studied 468 cases of early gastric cancers using ME-NBI(magnifying endoscopy with narrow band imaging);particularly, cases with positive horizontal margins and misdiagnosed horizontal margin cases were investigated. The number of cases with positive horizontal and misdiagnosed horizontal margins were 7/450(1.5%)and 21/450(4.7%), respectively. These lesions were located on the M area and IIc type was the most frequent macroscopic type. Histologically, 15/27(%)cases with positive and misdiagnosed horizontal margins were of the differentiated type.

 (2)We studied cases of ESD(endoscopic submucosal dissection)of poorly differentiated adenocarcinoma. Before ESD, oral and anal sides were marked using ME-NBI. In total, 64 cases and 128 points were investigated. All points were confirmed by histology in correct. Further, the histological and ME-NBI findings were in agreement at 114/128(89.1%)points. Correctly identified cases were smaller in size than incorrectly identified cases. Furthermore, incorrectly identified cases had more inflammatory cell infiltration than correctly identified cases.

 (3)In this study, we examined 468 cases of early gastric cancer. The final pathological diagnoses were as follows:39 cases of moderately differentiated adenocarcinoma, 13 cases of poorly differentiated adenocarcinoma, and 2 cases of crawling type. The margin of the lesion was misdiagnosed using ME-NBI in 4/39(10.3%)cases. Out of these 4 cases, 1 case had crawling type and 3 cases had microtubule and poorly differentiated type.

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50巻3号 (2015年3月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院