Case studyWhite opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma
Section snippets
Patients and methods
Forty-six consecutive gastric neoplasias of 0-IIa type from 42 patients, which could be investigated by ME with NBI between April 2006 and October 2007 in Fukuoka University Chikushi Hospital, were included in this study. Preparation of the patient for ME was the same as for standard endoscopy. Briefly, 30 minutes prior to the endoscopic procedure, all the patients were asked to drink a mixture consisting of 100 mL of water with 10,000 units of pronase (Kaken Pharmaceutical Co. Ltd., Tokyo,
Results
By high-resolution nonmagnifying endoscopy with WLI alone, WOS could not be visualized in any of the lesions. WOS could be detected by ME with both WLI and NBI. Nevertheless, when using ME with NBI, the visualization of the WOS is much clearer, and the analysis of its morphology is much easier than when using ME with WLI. Therefore, the morphology was determined by using ME with NBI. WOS is more frequently present in adenomas than in carcinomas (78% vs 43%, respectively; P < .05, Table 1).
Discussion
We were the first to report the MV architecture as visualized by ME, which is characteristic for early gastric cancer,7 and we have demonstrated that ME based on the MVP is clinically useful for differentiating between gastric cancerous and noncancerous lesions by retrospective10 and prospective studies.11 According to our results, when we investigated gastric lesions of the superficial flat (0-IIb) type or superficial depressed (0-IIc) type by ME, an irregular MV pattern as visualized by ME
Acknowledgements
The English is this manuscript was revised by Miss K. Miller (Royal English Language Centre, Fukuoka, Japan).
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Presented at the 15th United European Gastroenterology Week, October 29, 2007, Paris, France (Gut 2007;56:A16).