Novel narrow-band imaging magnifying endoscopic classification for early gastric cancer.
BACKGROUND
Narrow-band imaging magnifying endoscopy is widely used in Japan, but still there is no set of consistent guidelines for gastric lesions.


OBJECTIVE
To introduce a new narrow-band imaging magnifying endoscopic classification and report the accuracy of diagnosis in comparison to underlying histopathology of gastric lesions.


METHODS
Two hundred and fifty-seven consecutive patients with early gastric cancer lesions were enrolled into this study. Narrow-band imaging magnifying images were classified into four categories based on abnormal microvascular patterns and irregularities in the superficial glandular structure: fine-network pattern, corkscrew pattern, intra-lobular loop pattern-1 and intra-lobular loop pattern-2. The narrow-band imaging magnifying endoscopic classification was compared with the histopathological findings.


RESULTS
Amongst the differentiated-type adenocarcinoma lesions, fine-network pattern, intra-lobular loop pattern-1, intra-lobular loop pattern-2 and corkscrew pattern were observed in 15.7%, 59.6%, 24.2% and 0.5%, respectively. Differentiated-type adenocarcinomas mainly exhibited fine-network pattern or intra-lobular loop pattern. In undifferentiated-type adenocarcinoma lesions, intra-lobular loop pattern-2 and corkscrew pattern were observed in 41.2% and 58.8%, respectively. Therefore, undifferentiated-type adenocarcinomas were all classified as intra-lobular loop pattern-2 and corkscrew pattern. The histopathological types were not equivalent with the narrow-band imaging magnifying classification categories (P<0.001).


CONCLUSIONS
The new narrow-band imaging magnifying classification that incorporates the intra-lobular loop pattern may be able to predict the histological subtype of most gastric carcinomas.
Yokoyama
Akira
A
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
Inoue
Haruhiro
H
Minami
Hitomi
H
Wada
Yoshiki
Y
Sato
Yoshitaka
Y
Satodate
Hitoshi
H
Hamatani
Shigeharu
S
Kudo
Shin-ei
SE
D000230:Adenocarcinoma / Q000145:classification* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology