Comparison of autofluorescence imaging endoscopic findings with pathologic findings after endoscopic submucosal dissection of gastric neoplasms.
OBJECTIVE
All epithelial cells emit autofluoresce, with tumor cells emitting weaker autofluorescence. We categorized patterns of autofluorescence imaging (AFI) and compared their clinical characteristics and pathology findings after endoscopic submucosal dissection.


METHODS
Twenty patients were enrolled, comprising 4 adenomas and 16 early gastric cancers. AFI findings were classified as follows: G0 (well-defined pink lesion on a green background with a clear interface over >/=50% of its area), G1 (pink-green mottled lesion on a green background with a clear interface over <50% of its area), P1 (pink-green mottled lesion on a purple background with a clear interface over <50% of its area), and P2 (vague lesion on a purple background with a clear interface over </=10% of its area).


RESULTS
Most of the patients (80%) were male, and their median age was 62.4 years (range: 46-78 years). The lesion sizes by white-light mode, AFI mode, and pathology were 20.8+/-13.1, 22.8+/-15.4, and 20.0+/-17.7 mm (mean+/-SD), respectively. Sixteen cases of adenocarcinoma were classified as follows: G0 (n=10), G1 (n=2), P1 (n=2), and P2 (n=2). The G0 group has no p53 positive lesions, unlike the non-G0 group (p=0.044). All cases with the P1 and P2 patterns were of the gastric and intestinal types, respectively.


CONCLUSIONS
AFI images of gastric tumors were categorized into four patterns that were useful for defining the resection margin in 87.5% of cases, with G0 being the most common pattern (62.5%).
Kim
Wan Jung
WJ
Institute for Digestive Research, SoonChunHyang University Hospital, Seoul, Korea.
Cho
Joo Young
JY
Jeong
Soung Won
SW
Kim
Kyoung Min
KM
Choi
Ik Sung
IS
Ham
Jeung Ho
JH
Lee
Bo Young
BY
Kim
Jin Oh
JO
Lee
Joon Seong
JS
Jin
So Young
SY