| Theme |
Current Status of Magnifying Endoscopy |
| Title |
Differential Diagnosis of Benign and Malignant Gastric Lesions |
| Author |
Mototsugu Kato |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Manabu Nakagawa |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Yuichi Shimizu |
Division of Endoscopy, Hokkaido University Hospital |
| Author |
Shoko Ono |
Department of Gastroenterology, Hokkaido University School of Medicine |
| Author |
Masahiro Asaka |
Department of Gastroenterology, Hokkaido University School of Medicine |
| Author |
Souichi Nakagawa |
Nakagawa Ichouka |
| [ Summary ] |
Magnifying endoscopies have been remarkably improved to visualize the microstructure and microvascular architecture of the gastrointestinal mucosa. Narrow band imaging systems have especially contributed to the development of these systems. The microsurface structure of the mucosa, the so called pit pattern, includes the normal structure, changes in the structure, due to inflammation and biological responses, as well as tumor specific structures. On the other hand, the microvascular architecture includes normal vascular systems and tumorous microvessels. By assessing differences in the microsurface structure and microvascular architecture, useful information is supplied to diagnose early gastric cancer, benign lesions such as erythema, erosion, angiodysplasia, and intestinal metaplasia. The characteristic findings for intestinal type gastric cancer are fine pit patterns, destruction or disappearance of the mucosal microsurface structure with demarcation lines between the cancerous and noncancerous mucosa, as well as the presence of an irregular microvascular patterns. Findings for diffuse type gastric cancer reveal the absence of regular capillary network patterns and the presence of tumorous vessels. Magnifying endoscopic observation is helpful for the identification of early gastric cancer and differential diagnosis of benign lesions. |