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

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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.

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Acknowledgments

This work was supported in part by a Grant from the Japanese Foundation for Research and Promotion of Endoscopy.

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Authors and Affiliations

  1. Department of Endoscopy, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    Masaaki Kobayashi & Rintaro Narisawa

  2. Division of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, Niigata, Japan

    Manabu Takeuchi, Satoru Hashimoto, Akito Sato & Yutaka Aoyagi

  3. Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Yoichi Ajioka

Authors
  1. Masaaki Kobayashi
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  2. Manabu Takeuchi
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  3. Yoichi Ajioka
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  4. Satoru Hashimoto
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  5. Akito Sato
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  6. Rintaro Narisawa
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  7. Yutaka Aoyagi
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Correspondence to Masaaki Kobayashi.

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Kobayashi, M., Takeuchi, M., Ajioka, Y. et al. Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer. J Gastroenterol 46, 1064–1070 (2011). https://doi.org/10.1007/s00535-011-0418-6

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  • DOI: https://doi.org/10.1007/s00535-011-0418-6

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