Findings of the margin around lesions by magnifying endoscopy with narrow-band imaging in early gastric carcinoma and intestinal metaplasia.
OBJECTIVE
Many endoscopists have reported their own classifications of early gastric carcinoma (EGC) using magnifying narrow-band imaging (M-NBI). However, few reports on classifying the margin around lesions by M-NBI have been published. The aim of this study was to advocate the usefulness of the demarcation area classification for the diagnosis of EGC.


METHODS
Altogether 197 lesions that could be investigated by M-NBI were included in this study, consisting of 115 EGC and 82 intestinal metaplasias (IM). We hypothesized that the changes in white zone (fusion and erasure signs) and blood vessel (extend and draw sign) were the indications of EGC and we retrospectively investigated this hypothesis.


RESULTS
For the investigation of the white zone in the demarcation area, both fusion (P < 0.0001) and erasure signs (P < 0.0001) were observed more often in EGC than in IM, with an accuracy of 80.7%. For the investigation of blood vessel in the demarcation area, both the extend (P < 0.001) and the draw sign (P < 0.0001) were observed more often in EGC than in IM, with an accuracy of 59.9%.


CONCLUSIONS
Estimations of the white zone and blood vessels in the demarcation area are useful for the diagnosis of EGC.
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Kazu
K
Hamada
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Tohru
T
Itoh
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Ken
K
Kawaura
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Sadafumi
S
Azukisawa
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Rika
R
Kobayashi
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Hideyuki
H
Okamura
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Hidekazu
H
Kitakata
Department of Gastroenterological Endoscopy, School of Kanazawa Medical University, Ishikawa, Japan.
Sachio
S
Urashima
Department of Pathology, School of Kanazawa Medical University, Ishikawa, Japan.
Takayuki
T
Nojima
Hasune Royal Clinic, Tokyo, Japan.
Masayuki A
MA
Fujino
D001706:Biopsy; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008679:Metaplasia / Q000175:diagnosis; D062048:Narrow Band Imaging / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000473:pathology; D011230:Precancerous Conditions / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology
demarcation area; early gastric carcinoma; intestinal metaplasia; magnified finding; narrow-band imaging