Magnifying Endoscopy with Narrow Band Imaging of Early Gastric Cancer: Correlation with Histopathology and Mucin Phenotype
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Background/Aims: Magnifying endoscopy with narrow band imaging (ME-NBI) is a useful modality for the detailed visualization of microsurface (MS) and microvascular (MV) structures in the gastrointestinal tract. This study aimed to determine whether the MS and MV patterns in ME-NBI differ according to the histologic type, invasion depth, and mucin phenotype of early gastric cancers (EGCs). Methods: The MS and MV patterns of 160 lesions in 160 patients with EGC who underwent ME-NBI before endoscopic or surgical resection were prospectively collected and analyzed. EGCs were categorized as either differentiated or undifferentiated and as either mucosal or submucosal, and their mucin phenotypes were determined via immunohistochemistry of the tumor specimens. Results: Differentiated tumors mainly displayed an oval and/or tubular MS pattern and a fine network or loop MV pattern, whereas undifferentiated tumors mainly displayed an absent MS pattern and a corkscrew MV pattern. The destructive MS pattern was associated with submucosal invasion, and this association was more prominent in the differentiated tumors than in the undifferentiated tumors. MUC5AC expression was increased in lesions with either a papillary or absent MS pattern and a corkscrew MV pattern, whereas MUC6 expression was increased in lesions with a papillary MS pattern and a loop MV pattern. CD10 expression was more frequent in lesions with a fine network MV pattern. Conclusions: ME-NBI can be useful for predicting the histopathology and mucin phenotype of EGCs.
Abstract
Background/Aims: Magnifying endoscopy with narrow band imaging (ME-NBI) is a useful modality for the detailed visualization of microsurface (MS) and microvascular (MV) structures in the gastrointestinal tract. This study aimed to determine whether the MS and MV patterns in ME-NBI differ according to the histologic type, invasion depth, and mucin phenotype of early gastric cancers (EGCs). Methods: The MS and MV patterns of 160 lesions in 160 patients with EGC who underwent ME-NBI before endoscopic or surgical resection were prospectively collected and analyzed. EGCs were categorized as either differentiated or undifferentiated and as either mucosal or submucosal, and their mucin phenotypes were determined via immunohistochemistry of the tumor specimens. Results: Differentiated tumors mainly displayed an oval and/or tubular MS pattern and a fine network or loop MV pattern, whereas undifferentiated tumors mainly displayed an absent MS pattern and a corkscrew MV pattern. The destructive MS pattern was associated with submucosal invasion, and this association was more prominent in the differentiated tumors than in the undifferentiated tumors. MUC5AC expression was increased in lesions with either a papillary or absent MS pattern and a corkscrew MV pattern, whereas MUC6 expression was increased in lesions with a papillary MS pattern and a loop MV pattern. CD10 expression was more frequent in lesions with a fine network MV pattern. Conclusions: ME-NBI can be useful for predicting the histopathology and mucin phenotype of EGCs.
참고문헌 (33)
- Yao K, "Novel magnified endoscopic findings of microvascular architecture in intramucosal gastric cancer", Gastrointest Endosc, 56, pp.279~284 (2002)
- Yokoyama A, "Novel narrow-band imaging magnifying endoscopic classification for early gastric cancer", Dig Liver Dis, 42, pp.704~708 (2010)
- Yagi K, "Magnifying endoscopy with narrow band imaging for early differentiated gastric adenocarcinoma", Dig Endosc, 20, pp.115~122 (2008)
- Nakayoshi T, "Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video)", Endoscopy, 36, pp.1080~1084 (2004)
- Yoshida T, "Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions", Gastrointest Endosc, 59, pp.288~295 (2004)
- Lee MW, "Predicting the invasion depth of esophageal squamous cell carcinoma: comparison of endoscopic ultrasonography and magnifying endoscopy", Scand J Gastroenterol, 49, pp.853~861 (2014)
- Saito S, "Imaging by magnifying endoscopy with NBI implicates the remnant capillary network as an indication for endoscopic resection in early colon cancer", Int J Surg Oncol, 2011, pp.242608~ (2011)
- Kanao H, "Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors", Gastrointest Endosc, 69(3 Pt 2), pp.631~636 (2009)
- Kikuchi D, "Usefulness of magnifying endoscopy with narrow-band imaging for determining tumor invasion depth in early gastric cancer", Gastroenterol Res Pract, 2013, pp.217695~ (2013)
- Kobara H, "Prediction of invasion depth for submucosal differentiated gastric cancer by magnifying endoscopy with narrow-band imaging", Oncol Rep, 28, pp.841~847 (2012)
- Ha Kim G, "CDX2 expression is increased in gastric cancers with less invasiveness and intestinal mucin phenotype", Scand J Gastroenterol, 41, pp.880~886 (2006)
- Kim DH, "Mucin expression in gastric cancer: reappraisal of its clinicopathologic and prognostic significance", Arch Pathol Lab Med, 137, pp.1047~1053 (2013)
- Koseki K, "Distinction of differentiated type early gastric carcinoma with gastric type mucin expression", Cancer, 89, pp.724~732 (2000)
- Yamazaki K, "Tumor differentiation phenotype in gastric differentiated-type tumors and its relation to tumor invasion and genetic alterations", World J Gastroenterol, 12, pp.3803~3809 (2006)
- Toki F, "Relationship between clinicopathological features and mucin phenotypes of advanced gastric adenocarcinoma", World J Gastroenterol, 16, pp.2764~2770 (2010)
- Gwang Ha Kim, "Clinicopathologic Significance of Gastric and Intestinal Phenotypic Marker Expression in Gastric Carcinomas", The Korean Journal of Internal Medicine, 20(3), pp.191~197 (2005), 대한내과학회
- Kocer B, "Prognostic significance of mucin expression in gastric carcinoma", Dig Dis Sci, 49, pp.954~964 (2004)
- Pinto-de-Sousa J, "Mucins MUC1, MUC2, MUC5AC and MUC6 expression in the evaluation of differentiation and clinico-biological behaviour of gastric carcinoma", Virchows Arch, 440, pp.304~310 (2002)
- Kobayashi M, "Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer", J Gastroenterol, 46, pp.1064~1070 (2011)
- Yoshida T, "The clinical meaning of a nonstructural pattern in early gastric cancer on magnifying endoscopy", Gastrointest Endosc, 62, pp.48~54 (2005)
- Japanese Gastric Cancer Association, "Japanese classification of gastric carcinoma: 3rd English edition", Gastric Cancer, 14, pp.101~112 (2011)
- Park do Y, "Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia", Am J Surg Pathol, 32, pp.524~533 (2008)
- Choi J, "Endoscopic prediction of tumor invasion depth in early gastric cancer", Gastrointest Endosc, 73, pp.917~927 (2011)
- Kwee RM, "The accuracy of endoscopic ultrasonography in differentiating mucosal from deeper gastric cancer", Am J Gastroenterol, 103, pp.1801~1809 (2008)
- Kudo S, "Diagnosis of colorectal tumorous lesions by magnifying endoscopy", Gastrointest Endosc, 44, pp.8~14 (1996)
- Kudo S, "Pit pattern in colorectal neoplasia: endoscopic magnifying view", Endoscopy, 33, pp.367~373 (2001)
- Ohtani H, "Differing microvasculature in the two major types of gastric carcinoma: a conventional, ultrastructural and ultrastructural immunolocalization study of von Willebrand factor", Virchows Arch A Pathol Anat Histopathol, 417, pp.29~35 (1990)
- Adachi Y, "Microvascular architecture of early gastric carcinoma: microvascular-histopathologic correlates", Cancer, 72, pp.32~36 (1993)
- Fukui H, "Magnifying pharmacoendoscopy:response of microvessels to epinephrine stimulation in differentiated early gastric cancers", Gastrointest Endosc, 64, pp.40~44 (2006)
- Tsukashita S, "MUC gene expression and histogenesis of adenocarcinoma of the stomach", Int J Cancer, 94, pp.166~170 (2001)
- Tajima Y, "Gastric and intestinal phenotypic marker expression in early differentiated-type tumors of the stomach: clinicopathologic significance and genetic background", Clin Cancer Res, 12, pp.6469~6479 (2006)
- Anagnostopoulos GK, "High-resolution magnification endoscopy can reliably identify normal gastric mucosa, Helicobacter pylori-associated gastritis, and gastric atrophy", Endoscopy, 39, pp.202~207 (2007)
- Pimentel-Nunes P, "A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions", Endoscopy, 44, pp.236~246 (2012)