title: Analysis of microvascular density in early gastric carcinoma using magnifying endoscopy with narrow-band imaging.
abstract: OBJECTIVE
  Intramucosal vascular density differs between differentiated and undifferentiated type gastric carcinomas. This study aimed to evaluate the microvascular density characteristics of these two types of carcinoma using magnifying endoscopy with narrow-band imaging (ME-NBI).
  
  
  METHODS
  In total, 42 differentiated and 10 undifferentiated types were evaluated. The microvessels observed using ME-NBI were extracted from stored still images and the microvascular density in the two carcinoma types was analyzed. Histological vascular density in resected specimens was also evaluated using CD34 immunostaining.
  
  
  RESULTS
  There were significant differences between the microvascular density in the differentiated and undifferentiated types of carcinoma (10.02 ± 4.72 % vs 4.02 ± 0.40 %; P < 0.001) using ME-NBI. Vascular density assessed histologically also differed significantly between differentiated and undifferentiated types in both the whole mucosal (5.81 ± 3.17 % vs 3.25 ± 1.21 %) and the superficial mucosal layers (0 - 100 μm) (6.38 ± 3.73 % vs 3.66 ± 1.46 %). However, the vascular density in the surrounding non-carcinomatous mucosa assessed using ME-NBI and histologically, was significantly lower in the differentiated than in the undifferentiated types (P < 0.001). There was good agreement between ME-NBI and histologically assessed microvascular density in both the whole (r = 0.740; P < 0.001) and superficial mucosal layers (r = 0.764; P < 0.001). White opaque substance (WOS) was seen in eight patients who had the differentiated type carcinoma. In almost all cases with WOS, the appearance of the carcinoma was discolored.
  
  
  CONCLUSIONS
  There was a close relationship between ME-NBI assessed microvascular density and histologically assessed vascular density in the mucosal layer. Microvascular density differed significantly between the differentiated and undifferentiated types of carcinoma assessed using ME-NBI.
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamura
authors.affiliation: Department of Pathology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Naganuma
authors.affiliation: Department of Pathology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Shibuya
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Nagasaki
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Eiki
authors.initials: E
authors.lastname: Nomura
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Sendai City Hospital, Miyagi, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Saito