title: Surface pattern classification by enhanced-magnification endoscopy for identifying early gastric cancers.
abstract: 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.
authors.affiliation: Department of Endoscopic Medicine, Mie University School of Medicine, Tsu, Japan.
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Hideki
authors.initials: H
authors.lastname: Toyoda
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kadowaki
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Ryo
authors.initials: R
authors.lastname: Kosaka
authors.forename: Shinpei
authors.initials: S
authors.lastname: Matsuzaki
authors.forename: Taizo
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Imoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
mesh_terms: 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