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

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...

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Bibliographic Details
Published in:Journal of gastroenterology 2011-09, Vol.46 (9), p.1064-1070
Main Authors: Kobayashi, Masaaki, Takeuchi, Manabu, Ajioka, Yoichi, Hashimoto, Satoru, Sato, Akito, Narisawa, Rintaro, Aoyagi, Yutaka
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adenocarcinoma - blood supply
Adenocarcinoma - classification
Adenocarcinoma - pathology
Aged
Aged, 80 and over
Cancer
Colorectal Surgery
Endoscopy
Endoscopy, Gastrointestinal - methods
Female
Gastric Mucosa - pathology
Gastroenterology
Genetic aspects
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Microvessels
Middle Aged
Mucins - metabolism
Oncology, Experimental
Original Article—Alimentary Tract
Phenotype
Stomach cancer
Stomach Neoplasms - blood supply
Stomach Neoplasms - classification
Stomach Neoplasms - pathology
Surgical Oncology
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Summary: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  
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-011-0418-6