Magnifying endoscopy of gastric epithelial dysplasia based on the morphologic characteristics.
OBJECTIVE
To investigate the difference in magnifying endoscopic findings of gastric epithelial dysplasias (GEDs) according to the morphologic characteristics.


METHODS
This study included 46 GED lesions in 45 patients who underwent magnifying endoscopy using narrow band imaging (ME-NBI) before endoscopic resection. During ME-NBI, the microvascular and microsurface (MS) patterns and the presence of light blue crest (LBC) and white opaque substance were investigated. GEDs were categorized as adenomatous, foveolar, and hybrid types, and their mucin phenotype was evaluated.


RESULTS
Of the 46 lesions, 27 (59%) were categorized as adenomatous, 15 (32%) as hybrid, and the remaining 4 (9%) as foveolar. All adenomatous GEDs showed the round pit and/or tubular MS patterns, all foveolar GEDs showed the papillary pattern, and hybrid GEDs showed mixed patterns (P < 0.001). LBC was more frequently observed in adenomatous GEDs than in hybrid or foveolar GEDs (52%, 33%, 0%, respectively), although this difference was not significant (P = 0.127). The papillary MS pattern was associated with MUC5AC and MUC6 expression, and the round pit and/or tubular MS patterns were associated with CD10 expression.


CONCLUSIONS
The MS pattern in ME-NBI findings is useful for predicting the morphologic category and mucin phenotype of GEDs, and ME-NBI findings may guide decisions regarding GED treatment.
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Hwa Mi
HM
Kang
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Gwang Ha
GH
Kim
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Do Youn
DY
Park
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Hong Ryeol
HR
Cheong
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Dong Hoon
DH
Baek
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Bong Eun
BE
Lee
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea.
Geun Am
GA
Song
D000236:Adenoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D004847:Epithelial Cells / Q000737:chemistry / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC / Q000032:analysis; D055272:Mucin-6 / Q000032:analysis; D062048:Narrow Band Imaging; D015260:Neprilysin / Q000032:analysis; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
D014408:Biomarkers, Tumor; C524678:MUC5AC protein, human; C524734:MUC6 protein, human; D055271:Mucin 5AC; D055272:Mucin-6; D015260:Neprilysin
Dysplasia; Magnifying endoscopy; Mucin; Narrow band imaging; Stomach