title: Novel magnified endoscopic findings of microvascular architecture in intramucosal gastric cancer.
abstract: BACKGROUND
  The color change observed endoscopically in early gastric cancer is thought to correlate with vascular density and architecture. This study investigated the endoscopic microvascular architecture in intramucosal gastric carcinoma in vivo.
  
  
  METHODS
  Intramucosal gastric carcinomas without ulceration in 27 patients were studied by using a new magnifying upper endoscope with attention to microvascular findings. The carcinomas were divided into two major types histologically: differentiated (18) and undifferentiated (9).
  
  
  RESULTS
  A regular subepithelial capillary network was demonstrated in noncancerous mucosa. The appearance of the carcinomas differed depending on histologic differentiation. With all of the differentiated carcinomas, there was a well-demarcated area where the regular capillary pattern of noncancerous mucosa had disappeared and irregular microvessels were proliferating. In contrast, with undifferentiated carcinomas there was only an ill-defined area with disappearance or a reduction in the density of capillaries in the noncancerous mucosa.
  
  
  CONCLUSIONS
  Magnified endoscopic observation of microvessels may be of assistance in the identification of intramucosal gastric carcinomas that exhibit only subtle changes in color and shape at standard endoscopy.
authors.affiliation: Department of Gastroenterology, Fukuoka University, Chikushi Hospital, Fukuoka, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Oishi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.forename: Tsuneyoshi
authors.initials: T
authors.lastname: Yao
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwashita
mesh_terms: D019723:Endoscopes; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008833:Microcirculation; D008853:Microscopy; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000473:pathology