Vessels within Epithelial Circle Pattern Takao Kanemitsu 1 , Kenshi Yao 1 , Masaki Miyaoka 1 , Toshiki Kojima 2 , Kenta Chuman 1 , Rino Hasegawa 1 , Gou Ikezono 1 , Kensei Ohtsu 2 , Yoichiro Ono 2 , Toshiharu Ueki 2 , Atsuko Ota 3 , Hiroshi Tanabe 3 , Seiji Haraoka 3 , Akinori Iwashita 3 1Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 胃癌 , 拡大内視鏡 , 乳頭腺癌 , VEC pattern pp.215-220
Published Date 2019/2/25
DOI https://doi.org/10.11477/mf.1403201583
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 Conventional endoscopy is not useful for the diagnosis of papillary adenocarcinoma, which is pathologically more malignant than tubular adenocarcinoma. We report a novel characteristic pattern of differentiated papillary adenocarcinoma observed through high-magnification endoscopy, wherein vessels in the subepithelial intercrypt stroma were surrounded by circular marginal crypt epithelium. Furthermore, in a case-control study, we previously reported that this VEC(vessels within epithelial circle)pattern was useful for preoperative histological diagnosis of papillary structures in early differentiated gastric cancer using narrow-band imaging with high-magnification endoscopy to visualize the VEC pattern. In addition, concomitant undifferentiated carcinoma and submucosal invasion were observed in approximately 25% of the VEC pattern-positive early gastric cancer lesions, which suggested that the VEC pattern is a useful preoperative predictive marker for high malignancy potential of gastric cancer.

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