Tatematsu Hidezumi, Miyahara Ryoji, Shimoyama Yoshie, Funasaka Kohei, Ohno Eizaburou, Nakamura Masanao, Kawashima Hiroki, Itoh Akihiro, Ohmiya Naoki, Hirooka Yoshiki, Watanabe Osamu, Maeda Osamu, Ando Takafumi, Goto Hidemi
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Asian Pac J Cancer Prev. 2013;14(5):2765-9. doi: 10.7314/apjcp.2013.14.5.2765.
A close association between patterns identified by magnifying narrow-band imaging (M-NBI) and histological type has been described. M-NBI patterns were also recently reported to be related to the mucin phenotype; however, detials remain unclear.
We investigated the cellular differentiation of gastric cancer lesions, along with their mucosal distribution observed by M-NBI. Ninety-seven depressed-type early gastric cancer lesions (74 differentiated and 23 undifferentiated adenocarcinomas) were visualized by M-NBI. Findings were divided into 4 patterns based on abnormal microvascular architecture: a chain loop pattern (CLP), a fine network pattern (FNP), a corkscrew pattern (CSP), and an unclassified pattern. Mucin phenotypes were judged as gastric (G-type), intestinal (I-type), mixed gastric and intestinal (M-type), and null (N-type) based on 4 markers (MAC5AC, MUC6, MUC2, and CD10). The relationship of each pattern of microvascular architecture with organoid differentiation indicated by cancer cell differentiation and its distribution in each histological type of early gastric cancer was investigated.
All CLP and FNP lesions were differentiated. The cancer cell distribution showed organoid differentiation in 84.2% (16/19) and 61.1% (22/36) of the two types of lesions, respectively, and there was a significant difference from the unclassified pattern with organoid differentiation (p<0.001). Almost all (94.7%; 18/19) CSP lesions were undifferentiated, and organoid differentiation was observed in 72.2% (13/18). There was a significant difference from the unclassified pattern with organoid differentiation (p<0.05).
Cellular differentiation and distribution are associated with microvascular architecture observed by M-NBI.
已描述了放大窄带成像（M-NBI）所识别的模式与组织学类型之间的密切关联。最近也有报道称M-NBI模式与粘蛋白表型有关；然而，细节仍不清楚。
我们研究了胃癌病变的细胞分化情况，以及通过M-NBI观察到的其黏膜分布。97个凹陷型早期胃癌病变（74个分化型腺癌和23个未分化腺癌）通过M-NBI进行了可视化。根据异常微血管结构将结果分为4种模式：链环模式（CLP）、细网模式（FNP）、螺旋模式（CSP）和未分类模式。基于4种标志物（MAC5AC、MUC6、MUC2和CD10）将粘蛋白表型判断为胃型（G型）、肠型（I型）、胃和肠混合型（M型）及无（N型）。研究了每种微血管结构模式与癌细胞分化所指示的类器官分化及其在各组织学类型早期胃癌中的分布之间的关系。
所有CLP和FNP病变均为分化型。两种病变类型中癌细胞分布分别显示84.2%（16/19）和61.1%（22/36）具有类器官分化，与具有类器官分化的未分类模式存在显著差异（p<0.001）。几乎所有（94.7%；18/19）的CSP病变为未分化型，72.2%（13/18）观察到类器官分化。与具有类器官分化的未分类模式存在显著差异（p<0.05）。
细胞分化和分布与M-NBI观察到的微血管结构相关。
