Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;36(5):3183-3191.
doi: 10.1007/s00464-021-08626-4. Epub 2021 Jul 29.

Association between mucin phenotype and lesion border detection using acetic acid-indigo carmine chromoendoscopy in early gastric cancers

Seung Min Hong  1 , Gwang Ha Kim  2 , Bong Eun Lee  1 , Moon Won Lee  1 , Da Mi Kim  1 , Dong Hoon Baek  1 , Geun Am Song  1
Affiliations

Association between mucin phenotype and lesion border detection using acetic acid-indigo carmine chromoendoscopy in early gastric cancers

Seung Min Hong et al. Surg Endosc. 2022 May.

Abstract

Background: For successful treatment of early gastric cancers (EGCs), it is crucial to define the horizontal border of the lesion with high accuracy. Acetic acid-indigo carmine (AI) chromoendoscopy has been used to determine the horizontal border in EGCs, but this technique is less potent in certain situations. Mucin phenotype in gastric cancers refers to biological differences in precursor lesions and differences in histopathologic findings, and it might affect AI chromoendoscopy findings. We aimed to investigate the association between mucin phenotype and AI chromoendoscopy findings in EGCs.

Methods: We prospectively evaluated 126 lesions in 126 patients with endoscopically diagnosed EGCs. Conventional endoscopy and AI chromoendoscopy findings of these lesions before treatment were prospectively analyzed. The border distinction between the lesion and surrounding mucosa was classified as distinct or indistinct on conventional endoscopy and AI chromoendoscopy, respectively. Mucin phenotypes were classified as gastric, intestinal, gastrointestinal, or null type by immunohistochemistry.

Results: The lesion borders were distinct in 46.8% (59/126) of the lesions assessed using conventional endoscopy and in 73.0% (92/126) of those assessed with AI chromoendoscopy (p < 0.001). The border distinction rate of differentiated-type cancers on AI chromoendoscopy was significantly higher than that on conventional endoscopy (66/71 [93.0%] vs. 34/71 [47.9%], p < 0.001), but the border distinction rate of undifferentiated-type cancers on AI chromoendoscopy was not different from that on conventional endoscopy (26/55 [47.3%] vs. 25/55 [45.5%], p = 0.848). Compared with conventional endoscopy, AI chromoendoscopy identified borders in a significantly higher percentage of gastric, intestinal, and gastrointestinal mucin types; however, there was no difference in AI chromoendoscopy findings according to the mucin phenotype (p = 0.271).

Conclusion: AI chromoendoscopy was effective in horizontal border delineation in differentiated-type EGCs, but not in undifferentiated-type EGCs. Mucin phenotype had no effect on border distinction using AI chromoendoscopy.

Keywords: Acetic acid; Chromoendoscopy; Early gastric cancer; Indigo carmine; Mucin.

PubMed Disclaimer

References

    1. Ko WJ, Song GW, Kim WH, Hong SP, Cho JY (2016) Endoscopic resection of early gastric cancer: current status and new approaches. Transl Gastroenterol Hepatol 1:24 - DOI
    1. Oda I, Gotoda T, Hamanaka H, Eguchi T, Saito Y, Matsuda T, Bhandari P, Emura F, Saito D, Ono H (2005) Endoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and complications from a large consecutive series. Dig Endosc 17:54–58 - DOI
    1. Oka S, Tanaka S, Kaneko I, Mouri R, Hirata M, Kanao H, Kawamura T, Yoshida S, Yoshihara M, Chayama K (2006) Endoscopic submucosal dissection for residual/local recurrence of early gastric cancer after endoscopic mucosal resection. Endoscopy 38:996–1000 - DOI
    1. Fukunaga S, Nagami Y, Shiba M, Ominami M, Tanigawa T, Yamagami H, Tanaka H, Muguruma K, Watanabe T, Tominaga K, Fujiwara Y, Ohira M, Hirakawa K, Arakawa T (2017) Long-term prognosis of expanded-indication differentiated-type early gastric cancer treated with endoscopic submucosal dissection or surgery using propensity score analysis. Gastrointest Endosc 85:143–152 - DOI
    1. Jeon HK, Kim GH, Lee BE, Park DY, Song GA, Kim DH, Jeon TY (2018) Long-term outcome of endoscopic submucosal dissection is comparable to that of surgery for early gastric cancer: a propensity-matched analysis. Gastric Cancer 21:133–143 - DOI

LinkOut - more resources