Gut Liver.  2016 Jul;10(4):532-541. 10.5009/gnl15364.

Magnifying Endoscopy with Narrow Band Imaging of Early Gastric Cancer: Correlation with Histopathology and Mucin Phenotype

• Ok KS
• Kim GH
• Park DY
• Lee HJ
• Jeon HK
• Baek DH
• Lee BE
• Song GA

• KMID: 2412040
• DOI: http://doi.org/10.5009/gnl15364

Abstract

BACKGROUND/AIMS
Magnifying endoscopy with narrow band imaging (ME-NBI) is a useful modality for the detailed visualization of microsurface (MS) and microvascular (MV) structures in the gastrointestinal tract. This study aimed to determine whether the MS and MV patterns in ME-NBI differ according to the histologic type, invasion depth, and mucin phenotype of early gastric cancers (EGCs).
METHODS
The MS and MV patterns of 160 lesions in 160 patients with EGC who underwent ME-NBI before endoscopic or surgical resection were prospectively collected and analyzed. EGCs were categorized as either differentiated or undifferentiated and as either mucosal or submucosal, and their mucin phenotypes were determined via immunohistochemistry of the tumor specimens.
RESULTS
Differentiated tumors mainly displayed an oval and/or tubular MS pattern and a fine network or loop MV pattern, whereas undifferentiated tumors mainly displayed an absent MS pattern and a corkscrew MV pattern. The destructive MS pattern was associated with submucosal invasion, and this association was more prominent in the differentiated tumors than in the undifferentiated tumors. MUC5AC expression was increased in lesions with either a papillary or absent MS pattern and a corkscrew MV pattern, whereas MUC6 expression was increased in lesions with a papillary MS pattern and a loop MV pattern. CD10 expression was more frequent in lesions with a fine network MV pattern.
CONCLUSIONS
ME-NBI can be useful for predicting the histopathology and mucin phenotype of EGCs.

Keyword

Magnifying endoscopy; Narrow band imaging; Stomach neoplasms; Mucins

MeSH Terms

Adult
Aged
Aged, 80 and over
Early Detection of Cancer/*methods
Female
Gastric Mucosa/blood supply/diagnostic imaging
Gastrointestinal Tract/blood supply/diagnostic imaging
Gastroscopy/*methods
Humans
Image Enhancement/*methods
Male
Microvessels/diagnostic imaging
Middle Aged
Mucins/analysis
Narrow Band Imaging/*methods
Phenotype
Stomach Neoplasms/*diagnostic imaging/pathology
Mucins