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

Magnifying Narrow-band Imaging of Early Gastric Cancers Detected after Helicobacter pylori Eradication Masaaki Kobayashi 1 , Satoru Hashimoto 1 , Ken-ichi Mizuno 1 , Manabu Takeuchi 2 , Yuichi Sato 2 , Gen Watanabe 3 , Ken Nishikura 4 , Shuji Terai 2 , Yoichi Ajioka 3 1Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan 2Division of Gastroenterology, Niigata University Medical and Dental Hospital, Niigata, Japan 3Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan 4Department of Diagnostic Pathology, Saiseikai Niigata Daini Hospital, Niigata, Japan Keyword: H. pylori , 画像強調内視鏡 , 早期胃癌 , 質的診断 , 範囲診断 pp.289-299
Published Date 2015/3/25
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 We evaluated 100 early gastric cancers detected in 84 patients who received successful Helicobacter pylori eradication therapy. Narrow-band imaging with magnifying endoscopy(NBI-ME)findings for gastric cancers after eradication were characterized by homogeneous and regular microstructure bordered by clear“white zone”, resembling the adjacent non-cancerous mucosa. Because NBI-ME is a special modality for enhanced visualization of microstructures within the superficial layer of cancers, such as“gastritis-like”appearance, it correlated with histological surface differentiation and non-neoplastic superficial epithelium. Moreover, surface differentiation revealed cytological maturation at the luminal surface layer of cancers. This finding led to difficulty in a qualitative diagnosis of cancer by NBI-ME(n=19, Figs. 3 and 4). Non-neoplastic tubules among and/or on the cancer tubules caused unclear demarcation of cancers (n=12, Figs. 1 and 2). To accurately diagnose“gastritis-like”cancers after eradication, careful surveillance endoscopy is recommended, particularly for patients with mild mucosal atrophy.

Copyright © 2015, Igaku-Shoin Ltd. All rights reserved.


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