Surface pattern classification by enhanced-magnification endoscopy for identifying early gastric cancers.
BACKGROUND
The correlation between fine surface patterns of gastric mucosal lesions and early gastric cancer is not sufficiently clear.


OBJECTIVE
To evaluate the efficacy of surface pattern classification by enhanced-magnification endoscopy (EME) for identifying early gastric cancers.


METHODS
Observational study.


METHODS
All procedures were performed at Mie University Hospital.


METHODS
A total of 380 consecutive patients who underwent EGD by using magnification endoscopy. Among these subjects were found 250 newly detected lesions suspected of being gastric cancer.


METHODS
Conventional magnification endoscopy (CME), magnification chromoendoscopy (MCE), and EME were performed, and surface patterns of lesions were classified into 5 types: type I, small round pits of uniform size and shape; type II, slit-like pits; type III, gyrus and villous patterns; type IV, irregular arrangement and size; and type V, destructive pattern. Biopsy specimens were obtained from all lesions.


METHODS
Correlation between surface pattern classification by EME and histopathologic findings of early gastric cancer.


RESULTS
Surface patterns were evident by CME/MCE in only 66.4% (166/250) of lesions but in 100% (250/250) of lesions by EME. Classification by EME was as follows: type I, 52 lesions; type II, 12; type III, 146; type IV, 32; and type V, 8. By histopathologic examination, 16 early gastric cancers were detected between type IV or V lesions. Thus, classification of types IV-V strongly correlated with the presence of gastric cancer (sensitivity 100%, specificity 89.7%).


CONCLUSIONS
Single-center study.


CONCLUSIONS
Surface pattern classification by EME may be useful for identifying early gastric cancers.
Tanaka
Kyosuke
K
Department of Endoscopic Medicine, Mie University School of Medicine, Tsu, Japan.
Toyoda
Hideki
H
Kadowaki
Shigenori
S
Hamada
Yasuhiko
Y
Kosaka
Ryo
R
Matsuzaki
Shinpei
S
Shiraishi
Taizo
T
Imoto
Ichiro
I
Takei
Yoshiyuki
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D042241:Early Diagnosis; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery