Zheng Qian, Peng Yan, Liu Han Xiong, Cao Hui Qiu, Li Fang Fang
Department of Gastroenterology, Chenzhou First People's Hospital, 423000, China.
Department of Pathology, Chenzhou First People's Hospital, 423000, China.
Heliyon. 2024 Jun 1;10(12):e32293. doi: 10.1016/j.heliyon.2024.e32293. eCollection 2024 Jun 30.
In order to detect early gastric cancer (EGC), this research sought to assess the diagnostic utility of magnifying endoscopy (ME) as well as the significance of mucin phenotype and microvessel features.
402 individuals with an EGC diagnosis underwent endoscopic submucosal dissection (ESD) at the Department of ME between 2012 and 2020. After adjusting for image distortion, high-magnification endoscopic pictures were taken and examined to find microvessels in the area of interest. The microvessel density was measured as counts per square millimeter (counts/mm2) after segmentation, and the vascular bed's size was computed as a percentage of the area of interest. To identify certain properties of the microvessels, such as end-points, crossing points, branching sites, and connection points, further processing was done using skeletonized pixels.
According to the research, undifferentiated tumors often lacked the MS pattern and showed an oval and tubular microsurface (MS) pattern, but differentiated EGC tumors usually lacked the MS pattern and presented a corkscrew MV pattern. Submucosal invasion was shown to be more strongly associated with the destructive MS pattern in differentiated tumors as opposed to undifferentiated tumors. While lesions with a corkscrew MV pattern and an antrum or body MS pattern revealed greater MUC5AC expression, lesions with a loop MV pattern indicated higher MUC2 expression. Furthermore, CD10 expression was higher in lesions with a papillary pattern and an antrum or body MS pattern.
These results imply that evaluating mucin phenotype and microvessel features in conjunction with magnifying endoscopy (ME) may be a useful diagnostic strategy for early gastric cancer (EGC) detection. Nevertheless, further investigation is required to confirm these findings and identify the best course of action for EGC diagnosis.
为了检测早期胃癌（EGC），本研究旨在评估放大内镜（ME）的诊断效用以及黏蛋白表型和微血管特征的意义。
2012年至2020年间，402例被诊断为EGC的患者在ME科接受了内镜下黏膜下剥离术（ESD）。在调整图像失真后，拍摄高倍内镜图片并进行检查，以在感兴趣区域发现微血管。分割后，微血管密度以每平方毫米的计数（计数/mm²）来测量，血管床的大小以感兴趣区域的百分比来计算。为了识别微血管的某些特性，如端点、交叉点、分支部位和连接点，使用骨架化像素进行了进一步处理。
根据研究，未分化肿瘤通常缺乏MS模式，呈现椭圆形和管状微表面（MS）模式，而分化型EGC肿瘤通常缺乏MS模式，呈现螺旋状MV模式。与未分化肿瘤相比，分化型肿瘤的黏膜下浸润与破坏性MS模式的相关性更强。虽然具有螺旋状MV模式和胃窦或胃体MS模式的病变显示出更高的MUC5AC表达，但具有环状MV模式的病变显示出更高的MUC2表达。此外，具有乳头状模式和胃窦或胃体MS模式的病变中CD10表达更高。
这些结果表明，结合放大内镜（ME）评估黏蛋白表型和微血管特征可能是早期胃癌（EGC）检测的一种有用诊断策略。然而，需要进一步研究来证实这些发现，并确定EGC诊断的最佳行动方案。
