PDF(Pubmed)
Abstract：
BACKGROUND: At present, conventional endoscopy and chromoendoscopy using indigo carmine (IC) is a very useful method to determine the demarcation line (DL) of early gastric cancer lesions, but it is not suitable for all lesions.
OBJECTIVE: This study aimed to determine the applicable conditions for IC chromoendoscopy.
METHODS: We retrospectively evaluated 187 lesions in 181 patients who had an endoscopic diagnosis of EGC and were treated with endoscopic submucosal dissection (ESD). According to the existence of the DL between the lesion mucosa and normal mucosa with IC chromoendoscopy, the lesions were divided into two groups: clear group and unclear group. Clinicopathological characteristics were evaluated in each group. From January 2022 to March 2023, the postoperative pathological sections of 19 lesions (81 slices) in the clear group and 19 lesions (80 slices) in unclear group were scanned with high definition, and the crypt structure between the two groups was evaluated.
RESULTS: There was no significant difference in clinical factors between the clear group and unclear group. There were significant differences in crypt area, crypt length, and crypt opening diameter between the two groups. In the clear group, there were significant differences in crypt area, crypt length, and crypt opening diameter between the normal area and cancer area, but there was no significant difference in the unclear group.
CONCLUSIONS: The margins of lesions with fused or absent crypt structures, a small crypt area, a short crypt length, and a short crypt opening diameter can be easily determined with IC chromoendoscopy.
OBJECTIVE: This study aimed to determine the applicable conditions for IC chromoendoscopy.
METHODS: We retrospectively evaluated 187 lesions in 181 patients who had an endoscopic diagnosis of EGC and were treated with endoscopic submucosal dissection (ESD). According to the existence of the DL between the lesion mucosa and normal mucosa with IC chromoendoscopy, the lesions were divided into two groups: clear group and unclear group. Clinicopathological characteristics were evaluated in each group. From January 2022 to March 2023, the postoperative pathological sections of 19 lesions (81 slices) in the clear group and 19 lesions (80 slices) in unclear group were scanned with high definition, and the crypt structure between the two groups was evaluated.
RESULTS: There was no significant difference in clinical factors between the clear group and unclear group. There were significant differences in crypt area, crypt length, and crypt opening diameter between the two groups. In the clear group, there were significant differences in crypt area, crypt length, and crypt opening diameter between the normal area and cancer area, but there was no significant difference in the unclear group.
CONCLUSIONS: The margins of lesions with fused or absent crypt structures, a small crypt area, a short crypt length, and a short crypt opening diameter can be easily determined with IC chromoendoscopy.
摘要：
背景：目前，使用靛蓝(IC)的常规内镜和色素内镜是确定早期胃癌病变的分界线(DL)的非常有用的方法,但它并不适合所有的病变。
目的：本研究旨在确定IC色素内镜的适用条件。
方法：我们回顾性评估了181例内镜诊断为EGC并接受内镜黏膜下剥离术（ESD）治疗的患者中的187个病灶。根据病变粘膜与正常粘膜之间存在的DL，用IC染色内镜检查，病变分为2组：明确组和不明确组。评价各组的临床病理特征。2022年1月至2023年3月，对清晰组19个病灶（81片）和不清晰组19个病灶（80片）的术后病理切片进行高清晰度扫描，并评估两组间的隐窝结构。
结果：明确组与不明确组之间的临床因素没有显着差异。隐窝面积有显著差异,地穴长度,两组之间的隐窝开口直径。在清晰的群体中，隐窝面积有显著差异,地穴长度,正常区域和癌症区域之间的隐窝开口直径，但不清楚组没有显着差异。
结论：合并或缺失隐窝结构的病灶边缘，一个小小的隐窝区,一个短的隐窝长度，和一个短的隐窝开口直径可以很容易地确定与IC染色内镜。
目的：本研究旨在确定IC色素内镜的适用条件。
方法：我们回顾性评估了181例内镜诊断为EGC并接受内镜黏膜下剥离术（ESD）治疗的患者中的187个病灶。根据病变粘膜与正常粘膜之间存在的DL，用IC染色内镜检查，病变分为2组：明确组和不明确组。评价各组的临床病理特征。2022年1月至2023年3月，对清晰组19个病灶（81片）和不清晰组19个病灶（80片）的术后病理切片进行高清晰度扫描，并评估两组间的隐窝结构。
结果：明确组与不明确组之间的临床因素没有显着差异。隐窝面积有显著差异,地穴长度,两组之间的隐窝开口直径。在清晰的群体中，隐窝面积有显著差异,地穴长度,正常区域和癌症区域之间的隐窝开口直径，但不清楚组没有显着差异。
结论：合并或缺失隐窝结构的病灶边缘，一个小小的隐窝区,一个短的隐窝长度，和一个短的隐窝开口直径可以很容易地确定与IC染色内镜。
