1. Role of magnifying endoscopy with narrow‐band imaging in the diagnosis of noninvasive gastric neoplasia
- Author
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Yasuaki Ishida, Taisuke Inoue, Yoshimitsu Fukasawa, Masahiko Ohtaka, Tomoyoshi Uetake, Nobuyuki Enomoto, Keisuke Tanaka, Takashi Yoshida, Hiroko Shindo, Yukiko Asakawa, Shoji Kobayashi, Tadashi Sato, Shinichi Takano, Tatsuya Yamaguchi, Yuya Tsukui, Satoshi Kawakami, Mitsuharu Fukasawa, Toru Kuno, Masaru Muraoka, Shinya Maekawa, Yasuhiro Nakayama, Kunio Mochizuki, Shuya Matsuda, Hiroshi Hayakawa, and Fumihiko Iwamoto
- Subjects
medicine.medical_specialty ,Adenoma ,RC799-869 ,gastric adenoma ,Tp53 mutation ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Carcinoma ,cancer‐related gene mutations ,Narrow-band imaging ,magnifying narrow‐band imaging ,Hepatology ,business.industry ,Magnifying endoscopy ,Original Articles ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,gastric intramucosal carcinoma ,030220 oncology & carcinogenesis ,Intramucosal carcinoma ,Original Article ,030211 gastroenterology & hepatology ,Differential diagnosis ,business ,gastric noninvasive neoplasia ,Gastric Neoplasm - Abstract
Background and Aim There are no globally approved, distinguishing criteria enabling the classification of gastric adenomas and intramucosal carcinomas for differential diagnosis of noninvasive neoplasia (NIN). Methods Next‐generation sequencing of 50 cancer‐related genes was undertaken on 68 pathologically diagnosed microdissected gastric neoplasms (25 adenomas, 27 intramucosal carcinomas, and 16 submucosal carcinomas) obtained during endoscopic submucosal dissection. Findings from magnifying endoscopy with narrow‐band imaging (M‐NBI) of 52 NINs (the 25 adenomas and 27 intramucosal carcinomas) were compared with these data. Results Among all 68 neoplasms, the most frequently mutated genes were APC (76% in adenoma, 11.1% in intramucosal carcinoma, and 0% in submucosal carcinoma; P, Through a semiquantitative analysis of cancer‐related genes, it was found that noninvasive intraepithelial neoplasia (NIN) diagnosed as adenoma by both pathology and magnifying endoscopy with narrow‐band imaging (M‐NBI) had a profile of a single APC mutation, while NINs diagnosed as intramucosal carcinoma by both methods had a profile of TP53 mutation in most of the cases. On the other hand, some NINs were diagnosed as adenomas by pathology but were diagnosed as intramucosal carcinomas by M‐NBI, and such NINs with discrepant diagnoses had a characteristic profile of APC plus other mutation(s), suggesting that the M‐NBI finding reflects biological change and might be important for the diagnosis of NINs.
- Published
- 2021