title: Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer.
abstract: BACKGROUND
  Several studies have described the surface glandular structure in differentiated early gastric cancer observed by narrow-band imaging with magnifying endoscopy (NBI-ME) in two main patterns, i.e., a papillary or granular structure in an intralobular loop pattern (ILL) and a pit structure in a fine network pattern (FNP). However, it is uncertain why the NBI-ME findings of differentiated-type carcinomas are divided into two main patterns. We investigated the significance of the mucin phenotype in the morphogenetic difference between ILL and FNP.
  
  
  METHODS
  We evaluated 120 intramucosal, well- or predominantly well-differentiated tubular adenocarcinomas. In each lesion, one area that showed the predominant pattern of microsurface structures and microvessels was selected and marked by electrocoagulation for a strict comparative study by NBI-ME and pathological investigation. NBI-ME findings were classified into three patterns: ILL, FNP, and intermediate. Mucin phenotypes were judged as gastric, intestinal, or gastrointestinal type by immunohistochemistry.
  
  
  RESULTS
  The mucin phenotype was gastric or gastrointestinal type in 24 (92.3%) of 26 ILL lesions. Intestinal phenotype was observed in 22 (84.6%) of 26 FNP lesions. The gastrointestinal phenotype was observed in 50 (73.5%) of 68 intermediate pattern lesions. The mucin phenotype and NBI-ME results were significantly correlated (P < 0.001).
  
  
  CONCLUSIONS
  The mucin phenotype of differentiated early gastric cancer might be involved in morphogenetic differences between the papillary and pit structures visualized by NBI-ME.
authors.affiliation: Department of Endoscopy, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan. masakoba@med.niigata-u.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Manabu
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ajioka
authors.forename: Satoru
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Akito
authors.initials: A
authors.lastname: Sato
authors.forename: Rintaro
authors.initials: R
authors.lastname: Narisawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aoyagi
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000145:classification / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D010641:Phenotype; D013274:Stomach Neoplasms / Q000098:blood supply / Q000145:classification / Q000473:pathology*
chemical_list: D009077:Mucins