Usefulness of vessel plus surface classification system for the diagnosis of early gastric cancer after Helicobacter pylori eradication

Abstract

Background It has been reported that it is sometimes difficult to make a diagnosis of gastric cancer detected after Helicobacter pylori (H. pylori ) eradication. Therefore, we conducted a study to determine the usefulness of magnifying endoscopy using vessel plus surface classification system for making a diagnosis of early gastric cancer after H. pylori eradication. Method Usefulness of the markers of the vessel plus surface classification system for diagnosing gastric cancer using magnifying endoscopy with narrow-band imaging was investigated for gastric cancer detected after H. pylori eradication ( H. pylori -eradicated group) vs. H. pylori -positive gastric cancer ( H. pylori -positive group). Results 85 lesions were included in this study. The H. pylori -eradicated group comprised 27 lesions, whereas the H. pylori -positive group comprised 58 lesions. As for magnified endoscopic findings based on the vessel plus surface classification system, the respective positivity rates in the H. pylori -eradicated group vs. those in the H. pylori -positive group were as follows: demarcation line, 100% (27/27) vs. 100% (58/58); irregular microvascular pattern, 100% (27/27) vs. 100% (58/58); and irregular microsurface pattern, 78% (21/27) vs. 95% (55/58). There was no significant difference in the positivity rates of the demarcation line and irregular microvascular pattern between the groups. The positivity rate of the irregular microsurface pattern was significantly lower in the H. pylori -eradicated group than in the H. pylori -positive group (P = 0.03). Conclusion We presume that the microvascular pattern is more useful than the microsurface pattern as a diagnostic marker in cases of gastric cancer detected after H. pylori eradication.

Endoscopic, clinicopathological, and growth characteristics of minute gastric cancer

“…The rate of microsurface irregularity in MGC was significantly higher than that of microvascular irregularity, and microvascular irregularity was generally accompanied by microsurface irregularity. Both microsurface and microvascular irregularities could be valuable in diagnosing MGC, as in the large early gastric cancer 16,17 . In this study, there were two cases of regular microsurface and microvascular patterns.…”

“…Both microsurface and microvascular irregularities could be valuable in diagnosing MGC, as in the large early gastric cancer. 16,17 Our study showed that the antrum is the most common affected site for MGC, followed by the angular incisures, which is also the most common site for large gastric cancer. 21,22 In other words, large gastric cancer may originate from MGC.…”

Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis

“…Diffuse-type GC develops directly from highly active inflammation, whereas intestinal-type GC develops through destruction and replacement of tissues, such as atrophy and IM, and is termed Correa’s cascade[ 5 - 7 ]. GCs can also be described according to the different rates of incidence[ 8 , 9 ], lesion characteristics[ 10 - 12 ], and prognoses[ 13 - 16 ] as per the corresponding H. pylori infection status. In this editorial, we specifically describe the histological subtypes of GC and H. pylori infection status.…”