title: Fluorescein electronic endoscopy: a novel method for detection of early stage gastric cancer not evident to routine endoscopy.
abstract: BACKGROUND
  Fluorescence endoscopy with fluorescein sodium in the stomach was evaluated by using a newly developed fluorescence electronic endoscopic system.
  
  
  METHODS
  Sixteen patients with early stage gastric cancer diagnosed by white light endoscopy and chromoendoscopy underwent fluorescein electronic endoscopy before surgery. The resection specimens underwent thorough histopathologic evaluation.
  
  
  RESULTS
  About 10 seconds after intravenous injection of fluorescein, fluorescence appeared and immediately spread throughout the gastric surface. A few minutes later, differentiated early stage gastric cancers with more abundant stroma than surrounding normal mucosa exhibited significantly stronger fluorescence, and those with less stroma exhibited weaker fluorescence than the surrounding normal mucosa. Undifferentiated early stage gastric cancers, in which the stroma became wider because foveolae were collapsed from malignant invasion, expressed stronger fluorescence intensity. In all cases, the borders of early stage gastric cancers were clearly demonstrated. Among the 16 patients, 6 accompanying flat lesions and 1 tiny lesion not evident by routine endoscopy were detected. The extent of the cancers, as determined by fluorescence endoscopy, were similar to those determined histopathologically.
  
  
  CONCLUSIONS
  Fluorescein electronic endoscopy is useful in determining the extent within the mucosa of gastric cancers when this is obscure by standard endoscopic observation, and for detecting extremely early stage cancer that is not evident by conventional endoscopic observation.
authors.affiliation: Departments of Pathology, Surgery, and Internal Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
authors.forename: Ekapot
authors.initials: E
authors.lastname: Bhunchet
authors.forename: Hiroya
authors.initials: H
authors.lastname: Hatakawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Sakai
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Shibata
mesh_terms: D003287:Contrast Media; D004581:Electronics; D019793:Fluorescein; D005753:Gastric Mucosa / Q000473:pathology; D020699:Gastroscopes; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D003287:Contrast Media; D019793:Fluorescein