Clinical Gastroenterology Vol.25 No.3(7)

Theme Precancerous Conditions and Cancer High-risk Lesions in the Esophagus and the Stomach
Title Endoscopic Diagnosis of Malignant Potential of Gastric Adenomas
Publish Date 2010/03
Author Masayuki Kato Department of Endoscopy, The Jikei University School of Medicine
Author Mitsuru Kaise Department of Endoscopy, The Jikei University School of Medicine
Author Takashi Nakayoshi Department of Endoscopy, The Jikei University School of Medicine
Author Naoto Tamai Department of Endoscopy, The Jikei University School of Medicine
Author Hisao Tajiri Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
[ Summary ] Gastric adenoma, a benign neoplastic lesion in the stomach, is often difficult to correctly diagnose in terms of its malignant potential and how it differentiates it from cancer. We defined the following lesions as being 'highly-malignant adenoma';gastric lesions with a pre-ESD pathological diagnosis of adenoma, those with a final pathlogical diagnosis of ESD specimens, determined to be gastric cancer or a cancerous adenoma. Analyzing 192 adenomas diagnosed with pre-ESD patholgy, predicting factors for 'highly-malignant adenoma' were, severe atypia in biopsies, lesions larger than 2 cm in diameter, depressed type lesions or reddish lesions. Magnifying endoscopy with Narrow Band Imaging (ME-NBI) can enhance the diagnostic accuracy for these lesions.
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