Mechanisms Producing Color Change in Flat Early Gastric Cancers

Honmyo, Ubehiko; Misumi, Atsunobu; Murakami, Akinobu; Mizumoto, Seiichi; Yoshinaka, Ichirou; Maeda, Masakatsu; Yamamoto, Sohei; Shimada, Shoji

doi:10.1055/s-2007-1004217

Cited by 51 publications

(53 citation statements)

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“…In the previous pathologic studies, the vascularity of gastric carcinoma within the mucosa was shown to differ according to the degree of the histologic differentiation (2,21,22). It was found that the mucosal vascularity of differentiated carcinoma compared with the surrounding non-cancerous mucosa was higher or about the same in most lesions, but lower in a few.…”

Section: Discussionmentioning

confidence: 95%

“…The intestinal-type gastric carcinoma has the same color or reddening when compared with the surrounding non-cancerous mucosa, whereas the diffuse-type gastric carcinoma is discolored and has a paler color compared with the surrounding mucosa (1). Some pathologic studies have suggested that these color changes seen endoscopically in intramucosal gastric carcinoma seemed to be correlated with the vascularity within the carcinomatous mucosa (2). The endoscopic color of early gastric carcinoma has usually been described as reddened, the same, discolored, or pale when compared with the color of the surrounding non-cancerous mucosa (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…Some pathologic studies have suggested that these color changes seen endoscopically in intramucosal gastric carcinoma seemed to be correlated with the vascularity within the carcinomatous mucosa (2). The endoscopic color of early gastric carcinoma has usually been described as reddened, the same, discolored, or pale when compared with the color of the surrounding non-cancerous mucosa (1,2). Yet such descriptions are subjective, and it has not been possible to measure the color quantitatively.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

Kim¹,

Kim²,

Lim³

et al. 2007

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

Kim¹,

Kim²,

Lim³

et al. 2007

Gastrointestinal Endoscopy

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“…2a). On the other hand, FICE images with a set of wavelengths including 470 nm for blue (color gain level 4), 500 nm for green (5), and 550 nm for red (2) showed a flat and slightly brownish mucosal change, distinct from the surrounding yellowish area in the anterior wall (Fig. 2b).…”

Section: Case Reportmentioning

confidence: 99%

“…Current conventional endoscopy often misses flat early gastric cancers (0-IIb) because they are sometimes invisible [1,2]. Such flat gastric cancers have been detected by detailed histological examination of specimens resected by gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of small flat early gastric cancer by flexible spectral imaging color enhancement

Toma

Osawa

Yoshizawa

et al. 2010

Clin J Gastroenterol

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Current conventional endoscopy often misses flat early gastric cancers (0-IIb) because they are sometimes invisible. We experienced a case of small flat early gastric cancer that had been missed by normal-caliber conventional endoscopy. By small-caliber endoscope, conventional endoscopy showed a subtle reddish change of gastric mucosa, but the image with flexible spectral imaging color enhancement clearly showed a flat reddish lesion with 10 mm diameter, distinct from the surrounding mucosa. Flat early gastric cancer was suspected even though the lesion was not clearly described by conventional endoscopy. Histological examination of biopsy specimen revealed atypical glands. Endoscopic submucosal dissection of the lesion was performed. Pathological examination of the resected specimen confirmed well-differentiated adenocarcinoma localized in the mucosal layer without any depression or protrusion compared with the surrounding mucosa, consistent with the endoscopic finding. The small flat early gastric cancer became clearly visible with the new endoscopic technology.

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Diagnosis of histological type of early gastric cancer by magnifying narrow‐band imaging: A multicenter prospective study

et al. 2021

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Objectives Distinguishing undifferentiated‐type from differentiated‐type early gastric cancers (EGC) is crucial for determining the indication of endoscopic resection. We aimed to investigate the diagnostic performance of white‐light endoscopy (WLE) and magnifying narrow‐band imaging (M‐NBI) for the histological type of EGC. Methods In this multicenter prospective study, patients with histologically proven cT1 EGC, macroscopically depressed or flat type, size ≥5 mm, and without erosion/ulcer, were recruited. The diagnostic criterion of WLE for undifferentiated‐type EGC was pale color. The M‐NBI algorithm was created based on microsurface and microvascular patterns, and lesions with absent microsurface pattern and opened‐loop microvascular patterns were diagnosed as undifferentiated‐type. The center of the lesion was defined as the evaluation point and was initially evaluated by WLE, then by M‐NBI, and a biopsy specimen was taken as a reference standard. The primary and key secondary endpoints were overall diagnostic accuracy and specificity, respectively. Results In total, 167 lesions (122 differentiated‐type and 45 undifferentiated‐type EGCs) in 167 patients were analyzed. The overall accuracy, sensitivity, specificity, and positive likelihood ratio of WLE for undifferentiated‐type cancer were 80%, 69%, 84%, and 4.4, respectively, and those of M‐NBI were 82%, 53%, 93%, and 7.2, respectively. There was no significant difference in overall accuracy ( p = 0.755), but specificity was significantly higher in M‐NBI ( p = 0.041). Conclusions The use of M‐NBI did not improve the accuracy of WLE for the diagnosis of depressed/flat undifferentiated‐type EGCs but improved the specificity. It may reduce surgical overtreatment by preventing misdiagnosis of differentiated‐type EGC as undifferentiated‐type.

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Mechanisms Producing Color Change in Flat Early Gastric Cancers

Cited by 51 publications

References 0 publications

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

Diagnosis of small flat early gastric cancer by flexible spectral imaging color enhancement

Diagnosis of histological type of early gastric cancer by magnifying narrow‐band imaging: A multicenter prospective study

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