Magnifying pharmacoendoscopy: response of microvessels to epinephrine stimulation in differentiated early gastric cancers.
BACKGROUND
Magnifying endoscopy is a promising modality for fine observation of minute surface structures and microvessel architecture in gastric lesions.


OBJECTIVE
To observe the response of microvessels to epinephrine stimulation in early gastric cancer tissues and to assess the usefulness of magnifying pharmacoendoscopy for histologic diagnosis.


METHODS
This was a prospective pilot study.


METHODS
This study was conducted at an academic hospital.


METHODS
Twenty-nine patients with differentiated early gastric cancer were enrolled.


METHODS
Microvessels in both the cancerous lesion and its adjacent non-neoplastic gastric mucosa were observed by magnifying endoscopy before and after focal spray with epinephrine solution (0.05 mg/mL).


RESULTS
After epinephrine stimulation, noncancerous gastric mucosa surrounding the cancerous lesion showed a change in color from red to white; no microvessels were evident. On the other hand, all the cancerous lesions examined clearly showed enhancement of tumor microvessels. The rate of detection of tumor microvessels by magnifying pharmacoendoscopy (100%) was significantly higher than that by magnifying endoscopy alone (41.3%).


CONCLUSIONS
This was small pilot study.


CONCLUSIONS
Magnifying pharmacoendoscopy with epinephrine is a powerful tool for assessing tumor vascularity and may contribute to the histologic diagnosis of differentiated early gastric cancers before endoscopic treatment.
Fukui
Hirokazu
H
Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu Shimotsuga, Tochigi 321-0293, Japan.
Shirakawa
Katsuro
K
Nakamura
Tetsuya
T
Suzuki
Katsumasa
K
Masuyama
Hironori
H
Fujimori
Takahiro
T
Hiraishi
Hideyuki
H
Terano
Akira
A
D000368:Aged; D002454:Cell Differentiation; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D014662:Vasoconstrictor Agents; D004837:Epinephrine