Japanese

Magnifying Endoscopic Diagnosis of Extremely Well-differentiated Pure Adenocarcinoma of the Gastric Type Takao Kanemitsu 1 , Kenshi Yao 2 , Haruhiko Takahashi 1 , Takashi Nagahama 2 , Kenta Chuman 2 , Toshiki Kojima 1 , Shoko Fujiwara 2 , Masaki Miyaoka 2 , Toshiharu Ueki 1 , Rino Yamaoka 2,3 , Gou Ikezono 2,3 , Ken Kinjyo 1,3 , Atsuko Ota 3 , Hiroshi Tanabe 3 , Seiji Haraoka 3 , Akinori Iwashita 3 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 胃型 , 粘液形質 , 超高分化腺癌 , 低異型度胃癌 , 早期胃癌 pp.43-59
Published Date 2018/1/25
DOI https://doi.org/10.11477/mf.1403201259
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 Purpose:The following investigations were conducted to identify the characteristics of extremely well-differentiated adenocarcinomas of the gastric or gastric predominant type using M-NBI(magnifying endoscopy with narrow-band imaging).

 Methods:Of the early gastric cancer cases diagnosed at Fukuoka University Chikushi Hospital from January 2006 to July 2017 and treated using surgical resection or ESD, 12 were extremely well-differentiated pure adenocarcinomas of the gastric or gastric predominant-type, whose characteristic findings on M-NBI were then investigated. In addition, M-NBI findings were compared between extremely well-differentiated pure adenocarcinomas of the gastric or gastric predominant type and hyperplastic polyps of the foveolar type.

 Results:The M-NBI findings exhibited the following characteristics:1)MCE(the marginal crypt epithelium)in the lesions was wider than the surrounding mucosa(100%); 2)more cases were positive for VEC(vessels within the epithelial circle)pattern(58%); and 3)an irregular MV(microvascular)pattern was present(100%). Based on the M-NBI findings, significantly higher frequencies of irregular MV, irregular MS, and VEC patterns were observed in the extremely well-differentiated adenocarcinoma group than in the hyperplastic polyp group(p<0.01). Additionally, the hyperplastic polyp group exhibited higher frequencies of dilation and brown-black color changes in the intervening parts than those in the extremely well-differentiated adenocarcinoma group(p<0.01).

 Conclusion:The M-NBI findings of the irregular MV pattern were considered to be most important for the correct diagnosis of the gastric-type, extremely well-differentiated adenocarcinoma.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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