Novel zoom endoscopy technique for visualizing the microvascular architecture in gastric mucosa

We have developed and established a zoom endoscopy technique based on visualization of the mucosal microvascular architecture in units as small as the capillary in the normal stomach and early gastric cancer. With regard to the microvascular architecture of the normal stomach, the findings differed according to the section of the stomach. The gastric body showed a honeycomb-like subepithelial capillary network pattern with collecting venule, whereas the gastric antrum showed a coil-shaped subepithelial capillary network pattern. Regarding early gastric cancer, the following findings seemed to be specific for differentiated carcinoma: (1) a demarcation line between the cancerous and the noncancerous mucosa, (2) the disappearance of the regular subepithelial capillary network pattern, and (3) the presence of an irregular microvascular pattern. These findings, which were visualized by magnified observation, could be useful in clinical practice when we attempt to make a correct endoscopic diagnosis of flat reddened lesions (gastritis vs cancer) and when we attempt to determine the precise horizontal margin of early gastric cancer. This could help us to perform successful endoscopic resection based on endoscopic findings alone. In conclusion, our zoom endoscopy for visualizing the microvascular architecture in gastric mucosa could be a new system for diagnosing early gastric cancer.