Clinical Trials Study
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World J Gastroenterol. Nov 14, 2014; 20(42): 15771-15779
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15771
Magnifying endoscopy of gastric epithelial dysplasia based on the morphologic characteristics
Hwa Mi Kang, Gwang Ha Kim, Do Youn Park, Hong Ryeol Cheong, Dong Hoon Baek, Bong Eun Lee, Geun Am Song
Hwa Mi Kang, Department of Internal Medicine, Busan Adeventist Hospital, Busan 602-819, South Korea
Gwang Ha Kim, Hong Ryeol Cheong, Dong Hoon Baek, Bong Eun Lee, Geun Am Song, Department of Internal Medicine, Pusan National University School of Medicine, Busan 602-739, South Korea
Do Youn Park, Department of Pathology, Pusan National University School of Medicine, Busan 602-739, South Korea
Author contributions: Kim GH and Park DY designed the study; Cheong HY and Baek DH analyzed the data; Kim GH and Lee BE performed the study; Kang HM and Kim GH collected the data; Song GA reviewed the data of study population; and Kang HM and Kim GH wrote the paper.
Supported by Grant from the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, South Korea, No. A121994
Correspondence to: Gwang Ha Kim, MD, PhD, Department of Internal Medicine, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-gu, Busan 602-739, South Korea. doc0224@pusan.ac.kr
Telephone: +82-51-2407869 Fax: +82-51-2448180
Received: February 16, 2014
Revised: June 4, 2014
Accepted: June 25, 2014
Published online: November 14, 2014
Processing time: 274 Days and 13.6 Hours
Abstract

AIM: To investigate the difference in magnifying endoscopic findings of gastric epithelial dysplasias (GEDs) according to the morphologic characteristics.

METHODS: This study included 46 GED lesions in 45 patients who underwent magnifying endoscopy using narrow band imaging (ME-NBI) before endoscopic resection. During ME-NBI, the microvascular and microsurface (MS) patterns and the presence of light blue crest (LBC) and white opaque substance were investigated. GEDs were categorized as adenomatous, foveolar, and hybrid types, and their mucin phenotype was evaluated.

RESULTS: Of the 46 lesions, 27 (59%) were categorized as adenomatous, 15 (32%) as hybrid, and the remaining 4 (9%) as foveolar. All adenomatous GEDs showed the round pit and/or tubular MS patterns, all foveolar GEDs showed the papillary pattern, and hybrid GEDs showed mixed patterns (P < 0.001). LBC was more frequently observed in adenomatous GEDs than in hybrid or foveolar GEDs (52%, 33%, 0%, respectively), although this difference was not significant (P = 0.127). The papillary MS pattern was associated with MUC5AC and MUC6 expression, and the round pit and/or tubular MS patterns were associated with CD10 expression.

CONCLUSION: The MS pattern in ME-NBI findings is useful for predicting the morphologic category and mucin phenotype of GEDs, and ME-NBI findings may guide decisions regarding GED treatment.

Keywords: Stomach; Dysplasia; Narrow band imaging; Magnifying endoscopy; Mucin

Core tip: Microsurface patterns in the magnifying endoscopy using narrow band imaging (ME-NBI) are different according to the morphologic category and mucin phenotype in gastric epithelial dysplasias (GEDs). Considering that foveolar GEDs tend to be associated with high-grade morphology, ME-NBI findings such as the papillary microsurface pattern may guide decisions regarding GED treatment.