Abstract
The fine gastric mucosal patterns at the surface of the gastric mucosa were observed by using the magnifying fibergastroscope (FGS-ML) with about 30 magnifications. To simplify the fine gastric mucosal patterns, we made the magnifying endoscopic classification in the following ways; FP (foveolar pattern), FIP (foveolointermediate pattern), FSP (foveolosulciolar pattern), SP (sulciolar pattern) and MP(mesh pattern), which modified Yoshii's classification by means of dissecting microscope. The depressed parts (pastric pits) of the gastric mucosal surface, which showed FP, were consisted of circle. The depressed parts of SP and MP consist of sulcus, while the depressed parts of FSP were formed of tubule and sulcus. The term of FIP which was characterized by the circular and tubular depressed parts was adopted newly as our endoscopic classification. FIP is observed in more narrow space of the gastric mucosal surface which was knowen histologically as the intermediate zone. Gastrin producing cells in the gastric mucosa, which showed FIP, were rarely seen by immunof luorescence. Moreover, the rapid change from FP to FIP was estimated by observations in endoscopical comparison with two specimens from the resected and residual stomach. Therefore, we consider that the FIP indicates the atrophic border of the gastric mucosal surface. The magnifying endoscopic observation of the surface appearance of the intestinal metaplasia showed FSP and SP. By methyleneblue staining method, degrees of the methylene blue absorption were divided into "dense" and "rough" by magnifying observation . Tissue alkaline phosphatase activity in the intestinal metaplasia seemed to be in proportion to the degree of methylene blue stain. The fine gastric mucosal pattern at the surface of the gastric cancer was very irregular and easily differentiated from ordinary pattern. As the conclusion, we suggested the usefulness of the magnifying endoscopy in application of patho-physiological approach to the gastric mucosal changes in several gastric disorders.
