title: Prediction of submucosal gastric cancer by narrow-band imaging magnifying endoscopy.
abstract: BACKGROUND
  The features of gastric submucosal cancer revealed by magnifying endoscopy have not been reported. Aim of our study was to investigate whether magnifying endoscopy could contribute to the diagnosis of submucosal invasion.
  
  
  METHODS
  In this prospective, cross-sectional study, 197 lesions of gastric differentiated adenocarcinoma, diagnosed as mucosal cancer by conventional endoscopy, were observed by magnifying endoscopy with narrow-band imaging, paying attention to the presence of a blurry mucosal pattern and an irregular mesh pattern. After endoscopic submucosal dissection, all lesions were examined histologically and the areas of two features were estimated.
  
  
  RESULTS
  Among the lesions examined, 177 were diagnosed histologically as mucosal cancer and 20 as submucosal cancer. Multivariate logistic regression analysis confirmed that a blurry mucosal pattern (odds ratio 12.15, 95% confidence interval 3.45-42.76, p=0.000) and an irregular mesh pattern (22.55, 4.22-120.45, p=0.000) were independent predictors of submucosal invasion.
  
  
  CONCLUSIONS
  Narrow band imaging magnifying endoscopic features are useful for predicting submucosal invasion in gastric cancer.
authors.affiliation: Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan. Electronic address: yagikazu@pop12.odn.ne.jp.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yagi
authors.affiliation: Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Saka
authors.affiliation: Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Nozawa
authors.affiliation: Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: Division of Pathology, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Umezu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D062048:Narrow Band Imaging / Q000379:methods*; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
keywords: Gastric cancer; Magnifying endoscopy; Narrow band imaging; Submucosal invasion