Clinical Endoscopy

Original Article

Clinicopathological and endoscopic features of Helicobacter pylori infection-negative gastric cancer in Japan: a retrospective study: Kentaro Imamura, Kenshi Yao, Satoshi Nimura, Takao Kanemitsu, Masaki Miyaoka, Yoichiro Ono, Toshiharu Ueki, Hiroshi Tanabe; Clin Endosc 2024;57(4):486-494. Published online March 22, 2024; DOI: https://doi.org/10.5946/ce.2023.258

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Background
/Aims: Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC.
Methods
This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021. Only patients diagnosed with HPNGC were enrolled, and their clinicopathological and endoscopic features were analyzed in detail.
Results
The prevalence of HPNGC in the present study was 2.6% (54/2112). The types of HPNGC observed in each gastric region were as follows: advanced gastric cancer was observed in the cardia; gastric adenocarcinoma of fundic-gland differentiation, gastric adenocarcinoma of foveolar-type presenting with whitish elevation and raspberry-like foveolar-type gastric adenocarcinoma, gastric adenocarcinoma arising in polyposis, and gastric adenocarcinoma with autoimmune gastritis were observed in the fundic gland region ranging from the gastric fornix to the gastric body; signet-ring cell carcinoma was observed in the gastric-pyloric transition region ranging from the lower gastric body to the gastric angle; and well-differentiated tubular adenocarcinoma with low-grade atypia was observed in the antrum.
Conclusions
This study revealed that tumors from each gastric region exhibited distinct macroscopic and histological types in HPNGC.

Citations

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Is your endoscopist qualified enough to detect Helicobacter pylori-naive status?
Sun-Young Lee
Clinical Endoscopy.2024; 57(4): 466. CrossRef

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Review

The role of cap-assisted endoscopy and its future implications: Sol Kim, Bo-In Lee; Clin Endosc 2024;57(3):293-301. Published online February 7, 2024; DOI: https://doi.org/10.5946/ce.2023.051

Abstract PDF PubReader ePub: Cap-assisted endoscopy refers to a procedure in which a short tube made of a polymer (mostly transparent) is attached to the distal tip of the endoscope to enhance its diagnostic and therapeutic capabilities. It is reported to be particularly useful in: (1) minimizing blind spots during screening colonoscopy, (2) providing a constant distance from a lesion for clear visualization during magnifying endoscopy, (3) accurately assessing the size of various gastrointestinal lesions, (4) preventing mucosal injury during foreign body removal, (5) securing adequate workspace in the submucosal space during endoscopic submucosal dissection or third space endoscopy, (6) providing an optimal approach angle to a target, and (7) suctioning mucosal and submucosal tissue with negative pressure for resection or approximation. Here, we review various applications of attachable caps in diagnostic and therapeutic endoscopy and their future implications.

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Focused Review Series: Image-Enhanced Endoscopy: Update on Clinical Practice

Clinical Efficacy of Endocytoscopy for Gastrointestinal Endoscopy: Masashi Misawa, Shin-ei Kudo, Yuki Takashina, Yoshika Akimoto, Yasuharu Maeda, Yuichi Mori, Toyoki Kudo, Kunihiko Wakamura, Hideyuki Miyachi, Fumio Ishida, Haruhiro Inoue; Clin Endosc 2021;54(4):455-463. Published online July 7, 2021; DOI: https://doi.org/10.5946/ce.2021.165

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Endocytoscopy (EC) is a contact-type optical endoscope that allows in vivo cellular observation during gastrointestinal endoscopy and is now commercially available not only in Japan but also in Asian, European Union, and Middle Eastern countries. EC helps conduct a highly accurate pathological prediction without biopsy. Initially, EC was reported to be effective for esophageal diseases. Subsequently, its efficacy for stomach and colorectal diseases has been reported. In this narrative review, we searched for clinical studies that investigated the efficacy of EC. EC seems to accurately diagnose gastrointestinal diseases without biopsy. Most of the studies aimed to clarify the relationship between endocytoscopic findings of gastrointestinal neoplasia and pathological diagnosis. Some studies have investigated non-epithelial lesions or diseases, such as inflammatory bowel disease or infectious diseases. However, there are few high-level pieces of evidence, such as randomized trials; thus, further studies are needed.

Citations

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Endocitoscopia de la muscular propia en acalasia de rápida evolución y recidiva de acalasia post-Heller
Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
Gastroenterología y Hepatología.2024; 47(7): 761. CrossRef
Endocytoscopy of muscularis propria in rapidly evolving achalasia and recurrence of post-Heller achalasia
Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
Gastroenterología y Hepatología (English Edition).2024; 47(7): 761. CrossRef
Advanced Endoscopic Imaging for Assessing Mucosal Healing and Histologic Remission in Inflammatory Bowel Diseases
Tommaso Pessarelli, Gian Eugenio Tontini, Helmut Neumann
Gastrointestinal Endoscopy Clinics of North America.2024;[Epub] CrossRef
Automated Endoscopic Diagnosis in IBD
Yasuharu Maeda, Shin-ei Kudo, Takanori Kuroki, Marietta Iacucci
Gastrointestinal Endoscopy Clinics of North America.2024;[Epub] CrossRef
The diagnostic utility of endocytoscopy for the detection of gastric cancer: a systematic review and meta-analysis
Andrew CANAKIS, Shivanand BOMMAN, Benjamin TWERY, Nevin VARGHESE, Byung JI, Justin CANAKIS, Eric M. GOLDBERG
Minerva Gastroenterology.2024;[Epub] CrossRef
The diagnostic utility of endocytoscopy for the detection of esophageal lesions: A systematic review and meta-analysis
Lu Wang, Bofu Tang, Feifei Liu, Zhenyu Jiang, Xianmei Meng
Gastroenterology & Endoscopy.2023; 1(1): 12. CrossRef
A Review of Colonoscopy in Intestinal Diseases
Seung Hong, Dong Baek
Diagnostics.2023; 13(7): 1262. CrossRef
Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
Cancers.2023; 15(9): 2445. CrossRef
A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study
In Kyung Yoo, Jun Chul Park, Hyuk Lee, Abdullah Ozgur Yeniova, Jeong Hoon Lee, Dong Keon Yon, Joo Young Cho, Wan-Sik Lee
European Journal of Gastroenterology & Hepatology.2023; 35(5): 530. CrossRef
Advances and challenges in gastrointestinal endoscopy: a comprehensive review
Sun Gyo Lim
Journal of Innovative Medical Technology.2023; 1(1): 10. CrossRef
The development and clinical application of microscopic endoscopy for in vivo optical biopsies: Endocytoscopy and confocal laser endomicroscopy
Huahui Zhang, Zhongyu He, Ziyi Jin, Qinglai Yan, Peng Wang, Xuesong Ye
Photodiagnosis and Photodynamic Therapy.2022; 38: 102826. CrossRef
Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
Hee Seok Moon
Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef

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Original Articles

White Opaque Substance, a New Optical Marker on Magnifying Endoscopy: Usefulness in Diagnosing Colorectal Epithelial Neoplasms: Kazutomo Yamasaki, Takashi Hisabe, Kenshi Yao, Hiroshi Ishihara, Kentaro Imamura, Tatsuhisa Yasaka, Hiroshi Tanabe, Akinori Iwashita, Toshiharu Ueki; Clin Endosc 2021;54(4):570-577. Published online January 13, 2021; DOI: https://doi.org/10.5946/ce.2020.205

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Background
/Aims: A white substance that is opaque to endoscopic light is sometimes observed in the epithelium during narrowband imaging with magnifying endoscopy of gastric or colorectal epithelial neoplasms. This prospective observational study aimed to determine whether the morphology of the white opaque substance (WOS) allows differential diagnosis between colorectal adenoma and carcinoma.
Methods
A consecutive series of patients with colorectal adenomas or early carcinomas who underwent endoscopic resection or surgical excision were studied. The morphology of the WOS was determined based on endoscopic images before the histopathological diagnosis was performed. The primary outcome was the diagnostic performance of an irregular WOS as a marker of colorectal carcinoma.
Results
The study analyzed 125 lesions. A total of 33 lesions showed an irregular WOS, and 92 lesions showed a regular WOS. Among the 33 lesions found to show an irregular WOS, 30 were carcinomas. Among the 92 lesions showing a regular WOS, 79 were adenomas. With irregular WOS as a marker of carcinoma, the diagnostic accuracy was 87%, sensitivity was 91%, and specificity was 86%.
Conclusions
This study demonstrated the potential usefulness of the morphology of the WOS as a marker for the differential diagnosis between adenoma and carcinoma in cases of colorectal epithelial neoplasms.

Citations

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Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
Clinical Endoscopy.2022; 55(2): 315. CrossRef

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Histological Architecture of Gastric Epithelial Neoplasias That Showed Absent Microsurface Patterns, Visualized by Magnifying Endoscopy with Narrow-Band Imaging: Kenta Chuman, Kenshi Yao, Takao Kanemitsu, Takashi Nagahama, Masaki Miyaoka, Haruhiko Takahashi, Kentaro Imamura, Rino Hasegawa, Toshiharu Ueki, Hiroshi Tanabe, Seiji Haraoka, Akinori Iwashita; Clin Endosc 2021;54(2):222-228. Published online November 24, 2020; DOI: https://doi.org/10.5946/ce.2020.090

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Background
/Aims: The objective of this study was to elucidate the histological structure of the absent microsurface patterns (MSPs) that were visualized by magnifying endoscopy with narrow-band imaging (M-NBI).
Methods
The study included consecutive gastric epithelial neoplasias for which M-NBI findings and histological findings could be compared on a one-to-one basis. The lesions were classified as absent MSPs and present MSPs based on the findings obtained using M-NBI. Of the histopathological findings for each lesion that corresponded to M-NBI findings, crypt opening densities, crypt lengths, crypt opening diameters, intercrypt distances, and crypt angles were measured and compared.
Results
Thirty-six lesions were included in the analysis; of these, 17 lesions exhibited absent MSP and 19 lesions exhibited present MSP. Comparing the histological measurements for absent MSPs vs. present MSPs, median crypt opening density was 0.9 crypt openings/mm vs. 4.8 crypt openings/mm (p<0.001), respectively. The median crypt length, median crypt opening diameter, median intercrypt distance, and median crypt angle were 80.0 μm vs. 160 μm (p<0.001), 40.0 μm vs. 44.2 μm (p=0.09), 572.5 μm vs. 166.7 μm (p<0.001), and 21.6 degrees vs. 15.5 degrees (p<0.001), respectively.
Conclusions
Histological findings showed that lesions exhibiting absent MSPs had lower crypt opening density, shorter crypt length, greater intercrypt distance, and larger crypt angle.

Citations

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The staining results of early gastric cancer by indigo carmine chromoendoscopy associated with histological structure: a retrospective study
Xiaosa Jiang, Lingzhi Qin, Yujie Hao, Qian Yang, Yueqin Zheng, Baicang Zou, Lei Dong, Na Liu, Jinhai Wang, Bin Qin
BMC Cancer.2024;[Epub] CrossRef
Magnifying Endoscopy with Narrow-Band Imaging for Duodenal Neuroendocrine Tumors
Gwang Ha Kim, Kiyoun Yi, Dong Chan Joo, Moon Won Lee, Hye Kyung Jeon, Bong Eun Lee
Journal of Clinical Medicine.2023; 12(9): 3106. CrossRef

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2 Web of Science
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Focused Review Series: Current Status of Image-Enhanced Endoscopy (IEE)

Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach: Jung-Wook Kim; Clin Endosc 2018;51(6):527-533. Published online November 19, 2018; DOI: https://doi.org/10.5946/ce.2018.186

Abstract PDF PubReader ePub

There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopy with narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations with invasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imaging offers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitations of narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness in undifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use of endoscopic submucosal dissection for the treatment of gastric tumors.

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Assessment of Narrow-Band Imaging Algorithm for Video Capsule Endoscopy Based on Decorrelated Color Space for Esophageal Cancer: Part II, Detection and Classification of Esophageal Cancer
Yu-Jen Fang, Chien-Wei Huang, Riya Karmakar, Arvind Mukundan, Yu-Ming Tsao, Kai-Yao Yang, Hsiang-Chen Wang
Cancers.2024; 16(3): 572. CrossRef
Could near focus endoscopy, narrow-band imaging, and acetic acid improve the visualization of microscopic features of stomach mucosa?
Admir Kurtcehajic, Enver Zerem, Tomislav Bokun, Ervin Alibegovic, Suad Kunosic, Ahmed Hujdurovic, Amir Tursunovic, Kenana Ljuca
World Journal of Gastrointestinal Endoscopy.2024; 16(3): 157. CrossRef
Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention
Sergey M Kotelevets, Sergey A Chekh, Sergey Z Chukov
World Journal of Gastrointestinal Endoscopy.2024; 16(8): 462. CrossRef
Identification of gastric cancer with convolutional neural networks: a systematic review
Yuxue Zhao, Bo Hu, Ying Wang, Xiaomeng Yin, Yuanyuan Jiang, Xiuli Zhu
Multimedia Tools and Applications.2022; 81(8): 11717. CrossRef
Endoscopic diagnosis of early gastric cancer
Dong Chan Joo, Gwang Ha Kim
Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef
NBI utility in oncologic surgery: An organ by organ review
Francesca Boscolo Nata, Giancarlo Tirelli, Vincenzo Capriotti, Alberto Vito Marcuzzo, Erica Sacchet, Azzurra Nicole Šuran-Brunelli, Nicolò de Manzini
Surgical Oncology.2021; 36: 65. CrossRef
Updated Kimura-Takemoto classification of atrophic gastritis
Sergey M Kotelevets, Sergey A Chekh, Sergey Z Chukov
World Journal of Clinical Cases.2021; 9(13): 3014. CrossRef
Endoscopic Advances for Gastric Neoplasia Detection
Andrew Canakis, Raymond Kim
Gastrointestinal Endoscopy Clinics of North America.2021; 31(3): 543. CrossRef
Recent advances in diagnostic upper endoscopy
Jun-Liang Teh, Asim Shabbir, Soon Yuen, Jimmy Bok-Yan So
World Journal of Gastroenterology.2020; 26(4): 433. CrossRef
Narrowband imaging with near‐focus magnification for discriminating the gastric tumor margin before endoscopic resection: A prospective randomized multicenter trial
Jung‐Wook Kim, Yunho Jung, Jae‐Young Jang, Gwang Ha Kim, Byoung Wook Bang, Jun Chul Park, Hyuk Soon Choi, Jun‐Hyung Cho
Journal of Gastroenterology and Hepatology.2020; 35(11): 1930. CrossRef
Artificial Intelligence for the Prediction of Helicobacter Pylori Infection in Endoscopic Images: Systematic Review and Meta-Analysis Of Diagnostic Test Accuracy
Chang Seok Bang, Jae Jun Lee, Gwang Ho Baik
Journal of Medical Internet Research.2020; 22(9): e21983. CrossRef

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11 Web of Science
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Review

Application and Efficacy of Super-Magnifying Endoscopy for the Lower Intestinal Tract: Naoki Hosoe, Haruhiko Ogata; Clin Endosc 2016;49(1):37-40. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.37

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Endoscopy plays a significant role in the diagnosis, management, and surveillance of colorectal cancer (CRC) and inflammatory bowel diseases (IBDs). Moreover, magnifying endoscopy and image-enhanced endoscopy has a crucial role in the clinical setting. Recently, a super-magnifying endoscope has been developed, and two devices, confocal laser endomicroscopy (CLE) and an endocytoscopy system (ECS), which allow in vivo microscopic inspection of the microstructural mucosal features of the gastrointestinal tract, are currently available. Studies on the use of ECS in CRC were reported by a Japanese group. Additionally, a few studies on the use of ECS in IBD have been reported. CLE has been shown to be reliable in assessing the activity of the disease in IBDs in both ulcerative colitis and Crohn’s disease. Various published studies evaluated the use of CLE during colonoscopy to distinguish colorectal polyp pathology and neoplasia. However, these studies are heterogeneous, and further evidence is necessary to confirm the efficacy of CLE.

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From clinical uncertainties to precision medicine: the emerging role of the gut barrier and microbiome in small bowel functional diseases
Wojciech Marlicz, Diana E Yung, Karolina Skonieczna-Żydecka, Igor Loniewski, Saskia van Hemert, Beata Loniewska, Anastasios Koulaouzidis
Expert Review of Gastroenterology & Hepatology.2017; 11(10): 961. CrossRef

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Focused Review Series: Image Enhanced Endoscopys

Polyp Detection, Characterization, and Management Using Narrow-Band Imaging with/without Magnification: Takahiro Utsumi, Mineo Iwatate, Wataru Sano, Hironori Sunakawa, Santa Hattori, Noriaki Hasuike, Yasushi Sano; Clin Endosc 2015;48(6):491-497. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.491

Abstract PDF PubReader ePub

Narrow-band imaging (NBI) is a new imaging technology that was developed in 2006 and has since spread worldwide. Because of its convenience, NBI has been replacing the role of chromoendoscopy. Here we review the efficacy of NBI with/without magnification for detection, characterization, and management of colorectal polyps, and future perspectives for the technology, including education. Recent studies have shown that the next-generation NBI system can detect significantly more colonic polyps than white light imaging, suggesting that NBI may become the modality of choice from the beginning of screening. The capillary pattern revealed by NBI, and the NBI International Colorectal Endoscopic classification are helpful for prediction of histology and for estimating the depth of invasion of colorectal cancer. However, NBI with magnifying colonoscopy is not superior to magnifying chromoendoscopy for estimation of invasion depth. Currently, therefore, chromoendoscopy should also be performed additionally if deep submucosal invasive cancer is suspected. If endoscopists become able to accurately estimate colorectal polyp pathology using NBI, this will allow adenomatous polyps to be resected and discarded; thus, reducing both the risk of polypectomy and costs. In order to achieve this goal, a suitable system for education and training in in vivo diagnostics will be necessary.

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Clinical Application of Magnifying Endoscopy with Narrow-Band Imaging in the Stomach: Kenshi Yao; Clin Endosc 2015;48(6):481-490. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.481

Abstract PDF PubReader ePub

Magnifying endoscopy with narrow-band imaging (M-NBI) can visualize superficial microanatomies in the stomach. The normal morphology of the microanatomy visualized by M-NBI differs according to the part of the stomach. The gastric fundic glandular mucosa appears as a regular honeycomb-like subepithelial capillary network (SECN) pattern with a regular collecting venule pattern and regular oval crypt opening with circular marginal crypt epithelium (MCE) pattern. The gastric pyloric glandular mucosa displays a regular coil-shaped SECN pattern and regular polygonal or curved MCE pattern. For a diagnosis of early gastric cancer using M-NBI, the vessel plus surface classification system was developed. This system is clinically useful for the differential diagnosis of focal gastritis and small depressed cancer and for determining the horizontal extent of early gastric cancer for successful endoscopic resection. Advantages of M-NBI over conventional endoscopic imaging techniques with white light include accurate diagnosis and cost effectiveness. This technique is a breakthrough in the endoscopic diagnostic field.

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Focused Review Series: Globalization and Universalization of ESD

The Usefulness of Magnifying Endoscopy and Narrow-Band Imaging in Measuring the Depth of Invasion before Endoscopic Submucosal Dissection: Jae Young Jang; Clin Endosc 2012;45(4):379-385. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.379

Abstract PDF PubReader ePub

With the widespread application of endoscopic submucosal dissection for the treatment of gastrointestinal neoplasms, accurate determination of the invasion depth prior to intervention has become an indispensable part of treatment planning. Narrow-band imaging (NBI) is a novel endoscopic technique that may enhance the accuracy of diagnosis. Magnifying endoscopy with NBI has been shown to be effective for determining invasion depth for intrapapillary capillary loop classification of esophageal cancer and microvascular pattern of stomach cancer. Such precise pre-treatment staging of early neoplastic lesions in the gastrointestinal tract warrants timely initiation of disease-tailored treatment and, ultimately, better quality of life and improved patient survival.

Citations

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Interobserver Agreement in Gastric Lesions by Magnifying Endoscopy: Bong Min Ko, M.D., Jae Young Jang, M.D., Kwang An Kwon, M.D., Seong Hawn Kim, M.D.,; Korean J Gastrointest Endosc 2004;28(4):161-167. Published online April 30, 2004

Abstract PDF: Background
/Aims: Various magnifying endoscopic classifications have been introduced in esophageal and gastric lesions. However, studies on an agreement between observers according to the form classification of magnifiying endoscopic findings have not been performed yet. The aim of this study was to determine the interobserver agreement for magnifying endoscopic classifications.
Methods
The patients were divided into 3 groups. The first group of patients had post-EMR ulcer scar (50 cases), the second group, elevated gastric lesion (38 cases), and the third group, gastritis (43 cases). Two mucosal patterns were used in the post-EMR ulcer scar group, 6 mucosal patterns in the elevated gastric lesion group, and 3 patterns of the collecting venule in the gastritis group. Three experienced observers (A, B, C) blinded to the patients' data participated in this study. The agreement between observers was evaluated by calculated kappa. The kappa value of 0.75 or greater was rated excellent, 0.4∼0.74, fair to good, and 0.4 or less, poor. Results: Regarding 2 mucosal pattern in post- EMR ulcer scar, agreements between A and B, A and C, and B and C were 0.896, 0.793, and 0.901, respectively (p＜0.01). Regarding 6 mucosal patterns in elevated gastric lesion, agreements between A and B, A and C, and B and C were 0.607, 0.458, and 0.557, respectively (p＜0.01). Regarding 3 collecting venule pattern in gastritis, agreements between A and B, A and C, and B and C were 0.822, 0.823, and 0.751, respectively (p＜0.01). Conclusions: Interobserver agreement is good to excellent in mucosal pattern and collecting venule by magnifying endoscopy. However magnifying endoscopic classification needs to be refinded in order to improve an agreement between observers. (Korean J Gastrointest Endosc 2004;28:161⁣167)

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내시경적 점막절제술에서 확대내시경(Magnifying Endoscopy)과 확대안경(Magnifying LCD Glasses)의 경험: Korean J Gastrointest Endosc 2003;27(5):327-327. Published online November 20, 2003

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Correlation of Magnifying Endoscopy with Histology in the Gastric Mucosal Elevated Lesions: Jae Young Jang, M.D., In Seop Jung, M.D., Jin Oh Kim, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D., Boo Sung Kim, M.D. and So Young Jin, M.D.*; Korean J Gastrointest Endosc 2003;26(2):61-67. Published online February 28, 2003

Abstract PDF: Background
/Aims: This is the study to clarify the relation between the mucosal patterns by magnifying endoscopy and the histologic findings in the gastric mucosal elevated lesions. Methods: The objectives were 51 lesions from 48 patients with gastric mucosal elevated lesions. Gastric mucosal elevated lesions have been magnified up to 80 times by using the magnifying endoscope and were obtained tissue. Magnifying mucosal patterns were classified into 6 types (dot, sulciolar, reticular, irregular, destructive and abnormal vessel pattern) and two group (Group A: dot, sulciolar, reticular pattern-preservation of mucosal arrangement, Group B: irregular, destructive, abnormal vessel pattern-destruction of mucosal arrangement). And then we compared the relation between the mucosal patterns and the histologic findings in the gastric mucosal elevated lesions. Results: In magnifying mucosal patterns, dot, sulciolar, reticular, irregular, destructive, and abnormal vessel pattern were 8, 5, 15, 4, 12, 7, respectively. There was significant difference in the rate of severe dysplasia or carcinoma between two groups (Group A: 0% (0/28), Group B: 70% (16/23) (p＜0.05)). The score of intestinal metaplasia and atrophy in group A were less than that of group B (p＜0.05). Conclusions: Irregularity, destruction and abnormal vessel formation of gastric mucosal pattern by magnifying endoscope may be suspected the histologic malignancy in the gastric mucosal elevated lesions. (Korean J Gastrointest Endosc 2003;26:61⁣67)

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Corelation between the Finding of Magnifying Endoscopy and Histologic Finding in the Helicobactor Pylori Induced Gastritis: Jae Young Jang, M.D., Jun Sung Jung, M.D., Gab Jin Cheon, M.D., Kwon Ho Ryu, M.D.,Bo Young Lee, M.D., In Seop Jung, M.D., Chang Beom Ryu, M.D., Jin Oh Kim, M.D.,Joo Young Cho, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D.,Chan Sup Shim, M.D., Boo Sung K; Korean J Gastrointest Endosc 2002;25(6):431-437. Published online December 30, 2002

Abstract PDF: Background
/Aims: This is the study to find diagnostic possibility of the H. pylori induced gastritis by using the magnifying endoscope. Methods: The objectives were 144 pathologies from 48 patients with gastritis. The three sites of gastric mucosa have been magnified up to 80 times by using the magnifying endoscope. According to the patterns of the collecting venule, they have been classified into 3 patterns; regular (R), irregular (I) and disappearance (D) pattern and biopsy of each part has been performed. Each tissue has been evaluated into five kinds of morphological index (point: 0∼3) by using an updated Sydney system. Results: In 144 collecting venule, R, I and D-pattern was 19, 67, 58, respectively. Regarding the total score of morphologic points, the point of R-pattern was less than that of D-pattern (p＜0.05). Regarding the infection of H. pyrori, the infection rate was 0%, 53.7%, and 60.3% in each pattern, and infection rate of R-pattern was less than other two patterns (p＜0.05). Regarding the activity of neutrophile, R-pattern was less than those of I and D-pattern (p＜0.05). Conclusions: Observance of the collecting venule of the gastric mucosa by magnifying endoscopy is considered to be useful when estimating the inflammation degree and H. pylori infection. (Korean J Gastrointest Endosc 2002;25:431⁣437)

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