Journal of Gastroenterology

, Volume 46, Issue 9, pp 1064–1070

Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer

  • Masaaki Kobayashi
  • Manabu Takeuchi
  • Yoichi Ajioka
  • Satoru Hashimoto
  • Akito Sato
  • Rintaro Narisawa
  • Yutaka Aoyagi
Original Article—Alimentary Tract

DOI: 10.1007/s00535-011-0418-6

Cite this article as:
Kobayashi, M., Takeuchi, M., Ajioka, Y. et al. J Gastroenterol (2011) 46: 1064. doi:10.1007/s00535-011-0418-6

Abstract

Background

Several studies have described the surface glandular structure in differentiated early gastric cancer observed by narrow-band imaging with magnifying endoscopy (NBI-ME) in two main patterns, i.e., a papillary or granular structure in an intralobular loop pattern (ILL) and a pit structure in a fine network pattern (FNP). However, it is uncertain why the NBI-ME findings of differentiated-type carcinomas are divided into two main patterns. We investigated the significance of the mucin phenotype in the morphogenetic difference between ILL and FNP.

Methods

We evaluated 120 intramucosal, well- or predominantly well-differentiated tubular adenocarcinomas. In each lesion, one area that showed the predominant pattern of microsurface structures and microvessels was selected and marked by electrocoagulation for a strict comparative study by NBI-ME and pathological investigation. NBI-ME findings were classified into three patterns: ILL, FNP, and intermediate. Mucin phenotypes were judged as gastric, intestinal, or gastrointestinal type by immunohistochemistry.

Results

The mucin phenotype was gastric or gastrointestinal type in 24 (92.3%) of 26 ILL lesions. Intestinal phenotype was observed in 22 (84.6%) of 26 FNP lesions. The gastrointestinal phenotype was observed in 50 (73.5%) of 68 intermediate pattern lesions. The mucin phenotype and NBI-ME results were significantly correlated (P < 0.001).

Conclusions

The mucin phenotype of differentiated early gastric cancer might be involved in morphogenetic differences between the papillary and pit structures visualized by NBI-ME.

Keywords

Gastric phenotype Intestinal phenotype Intralobular loop pattern Fine network pattern 

Copyright information

© Springer 2011

Authors and Affiliations

  • Masaaki Kobayashi
    • 1
  • Manabu Takeuchi
    • 2
  • Yoichi Ajioka
    • 3
  • Satoru Hashimoto
    • 2
  • Akito Sato
    • 2
  • Rintaro Narisawa
    • 1
  • Yutaka Aoyagi
    • 2
  1. 1.Department of EndoscopyNiigata University Medical and Dental HospitalNiigataJapan
  2. 2.Division of Gastroenterology and HepatologyNiigata University Medical and Dental HospitalNiigataJapan
  3. 3.Division of Molecular and Diagnostic PathologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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