Oncological Gastroenterology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
Molecular Oncology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
Clin Exp Med. 2023 Jun;23(2):547-551. doi: 10.1007/s10238-022-00843-y. Epub 2022 Jun 1.
Linitis plastica (LP) is a very aggressive and rare carcinoma with a scirrhous stroma that affects the submucosal and muscular layers of the stomach even without mucosal alterations. Lack of timely diagnosis is a crucial problem related to its prognosis and treatment. In this study, we investigated the LP-associated vascular pattern as a possible means to improve the diagnosis of these patients. During standard endoscopy, mucosal architecture, tortuosity and enlargement of vessels, as well as the presence of vascular leakage and efficiency of the blood flow were assessed in six LP patients using probe-based Confocal Laser Endomicroscopy (pCLE). In all LP patients, we detected abnormal changes in vasculature. The aberrant features of the vascular network were common to all LP patients examined and consisted of vessel enlargement, tortuosity, and leakage associated with the affected submucosal layer. This is the first study to highlight the presence of marked vascularization associated with LP, characterized by the presence of abnormal and non-functional vessels, similar to what is observed in neoplastic tissues. Therefore, the analysis of LP by pCLE may provide a new endoscopic approach and strategy to better define these patients.
固有肌层纤维化（LP）是一种非常侵袭性和罕见的癌，其具有纤维基质，即使没有黏膜改变也会影响胃的黏膜下和肌层。缺乏及时诊断是与预后和治疗相关的一个关键问题。在这项研究中，我们研究了 LP 相关的血管模式，以期改善这些患者的诊断。在标准内镜检查过程中，使用基于探头的共聚焦激光内镜（pCLE）评估了 6 名 LP 患者的黏膜结构、血管迂曲和扩张、血管渗漏以及血流效率。在所有 LP 患者中，我们均检测到了血管的异常变化。受影响的黏膜下层的血管扩张、迂曲和渗漏与所有检查的 LP 患者的网络异常特征有关。这是第一项强调 LP 相关的明显血管生成的研究，其特征是存在异常和无功能的血管，类似于在肿瘤组织中观察到的情况。因此，pCLE 对 LP 的分析可能为更好地定义这些患者提供了一种新的内镜方法和策略。
