Prediction of submucosal gastric cancer by narrow-band imaging magnifying endoscopy

Abstract

The features of gastric submucosal cancer revealed by magnifying endoscopy have not been reported. Aim of our study was to investigate whether magnifying endoscopy could contribute to the diagnosis of submucosal invasion. In this prospective, cross-sectional study, 197 lesions of gastric differentiated adenocarcinoma, diagnosed as mucosal cancer by conventional endoscopy, were observed by magnifying endoscopy with narrow-band imaging, paying attention to the presence of a blurry mucosal pattern and an irregular mesh pattern. After endoscopic submucosal dissection, all lesions were examined histologically and the areas of two features were estimated. Among the lesions examined, 177 were diagnosed histologically as mucosal cancer and 20 as submucosal cancer. Multivariate logistic regression analysis confirmed that a blurry mucosal pattern (odds ratio 12.15, 95% confidence interval 3.45-42.76, p=0.000) and an irregular mesh pattern (22.55, 4.22-120.45, p=0.000) were independent predictors of submucosal invasion. Narrow band imaging magnifying endoscopic features are useful for predicting submucosal invasion in gastric cancer.