Surface pattern classification by enhanced-magnification endoscopy for identifying early gastric cancers
Related Experiment Video
Updated: Jul 7, 2026
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Kyosuke Tanaka1, Hideki Toyoda, Shigenori Kadowaki
1Department of Endoscopic Medicine, Mie University School of Medicine, Tsu, Japan.
Background:
The correlation between fine surface patterns of gastric mucosal lesions and early gastric cancer is not sufficiently clear.
Objective:
To evaluate the efficacy of surface pattern classification by enhanced-magnification endoscopy (EME) for identifying early gastric cancers.
Design:
Observational study.
Setting:
All procedures were performed at Mie University Hospital.
Patients:
A total of 380 consecutive patients who underwent EGD by using magnification endoscopy. Among these subjects were found 250 newly detected lesions suspected of being gastric cancer.
Methods:
Conventional magnification endoscopy (CME), magnification chromoendoscopy (MCE), and EME were performed, and surface patterns of lesions were classified into 5 types: type I, small round pits of uniform size and shape; type II, slit-like pits; type III, gyrus and villous patterns; type IV, irregular arrangement and size; and type V, destructive pattern. Biopsy specimens were obtained from all lesions.
Main Outcome Measurements:
Correlation between surface pattern classification by EME and histopathologic findings of early gastric cancer.
Results:
Surface patterns were evident by CME/MCE in only 66.4% (166/250) of lesions but in 100% (250/250) of lesions by EME. Classification by EME was as follows: type I, 52 lesions; type II, 12; type III, 146; type IV, 32; and type V, 8. By histopathologic examination, 16 early gastric cancers were detected between type IV or V lesions. Thus, classification of types IV-V strongly correlated with the presence of gastric cancer (sensitivity 100%, specificity 89.7%).
Limitations:
Single-center study.
Conclusions:
Surface pattern classification by EME may be useful for identifying early gastric cancers.
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