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Japanese

The Mechanisms How to Visualize Poor Distensibility of the Gastric Wall and "Non Extension Sign" by Conventional Endoscopy Takashi Nagahama 1 , Toshiki Kojima 2 , Kenta Chuuman 2 , Kenshi Yao 2 , Hiroshi Tanabe 3 , Seiji Haraoka 3 1Nagahama GIE Clinic, Fukuoka, Japan 2Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 通常内視鏡 , 伸展不良所見 , 台状挙上所見 , 粘膜下層浸潤 , 潰瘍瘢痕 , 深達度診断 pp.1252-1259
Published Date 2018/8/25
DOI https://doi.org/10.11477/mf.1403201462
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 This study outlines the poor extension findings typically observed in endoscopic imaging in patients with early gastric cancer. In cancer types T1a-T1b1, the wall flexibility is broadly maintained(i.e., it exhibits favorable extension)similar to the nontumorous mucosa during robust gastric wall extension. Typical pathological conditions that exhibit poor extension findings in patients with early gastric cancer are observed in two cancer types [T1a, UL2 and T1b, UL2] with substantial invasive carcinoma(T1b2)infiltrating into the submucosa(SM)and ulceration(scarring). In T1b2, cancer cell mass, inflammatory cell infiltration, and neoplastic fibrosis cause massive localized thickening and hardening. When air is blown through an endoscope to extensively extend the stomach wall, well-demarcated and elevated signs appear because of differing extensibility between the noninfiltrated part and SM infiltrated part. Furthermore, in T1a-T1b1, the coexistence of ulceration is primarily due to SM layer fibrosis, resulting in thickening and hardening and the appearance of poor extension, which are typical findings of mucosal fold convergence. However, as the fibrosis displays poor demarcation during robust gastric wall extension, the mucosal fold linearly convergences at a single point without elevation, signifying a negative well-demarcated elevation.


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

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