title: Magnifying pharmacoendoscopy: response of microvessels to epinephrine stimulation in differentiated early gastric cancers.
abstract: 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.
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu Shimotsuga, Tochigi 321-0293, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.forename: Katsuro
authors.initials: K
authors.lastname: Shirakawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hironori
authors.initials: H
authors.lastname: Masuyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hiraishi
authors.forename: Akira
authors.initials: A
authors.lastname: Terano
mesh_terms: 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*
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine