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Endoscopic Diagnosis of Gastric Subepithelial Tumors:Focusing on Lesions that are Localized in the Mucosal Layer within the Gastric Wall Takao Kanemitsu 1 , Kenshi Yao 1 , Shuntaro Uno 2 , Hisatomi Arima 3 , Ken Kinjo 4 , Rino Hasegawa 1 , Masaki Miyaoka 1 , Toshiharu Ueki 4 , Takayuki Hirase 4,5 , Satoshi Nimura 5 1Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Gastroenterology, Sada Hospital, Fukuoka, Japan 3Department of Preventive Medicine & Public Health, Fukuoka University Faculty of Medicine, Fukuoka, Japan 4Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 5Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 胃上皮下腫瘍 , 粘膜固有層 , NBI併用拡大観察 , 表面微細構造 , 微小血管構築像 pp.623-634
Published Date 2023/5/25
DOI https://doi.org/10.11477/mf.1403203224
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 Objective:Given the few reports on the diagnosis of gastric SETs(subepithelial tumors)based on a systematic review of endoscopic findings, including those obtained by magnifying endoscopy, this study aimed to determine the relationship between the morphology and intramural localization of gastric SETs, particularly in lesions localized in the mucosal layer.

 Method:Endoscopic and histopathologic findings of gastric SETs were retrospectively evaluated with localization in the mucosal lamina propria(or in the mucosal lamina propria and submucosa), which were endoscopically or surgically resected at Fukuoka University Chikushi Hospital between January 2013 and November 2022. The primary end-point of this study was to determine the association between the conventional and M-NBI(magnifying endoscopy with narrow-band imaging)and histopathological findings in gastric SETs.

 Results:Twenty-four lesions were analyzed in this study:10 neuroendocrine tumor G1, 12 gastric adenocarcinomas of fundic gland type, and 2 gastric carcinomas with lymphoid stroma. With the increasing number of lesions detected by conventional endoscopy, a steep increase(p<0.001)and decrease of the lesion surface(p=0.008)were associated with the vertical tumor diameter of the lesion. The open interorbital area(p=0.018), absent microsurface pattern(p=0.002), and opened microvascular pattern(p=0.009)observed by M-NBI were associated with the distance between the superficial epithelium and the apex of the lesion.

 Conclusion:Our results suggest a relationship between endoscopic and histopathologic findings in gastric SETs with lesions localized in the mucosal lamina propria(or in the mucosal lamina propria and submucosa). However, this retrospective study consisted of a very small number of cases ; thus, further validation is needed after accumulating more cases.


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

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