MORPHOLOGICAL AND FUNCTIONAL STUDIES ON ENDOSCOPIC ATROPHIC BORDER, MAINLY INTERMEDIATE ZONE

Abstract

By the application of endoscopic congo red method, the patterns are classified according to Kimura's classification. At this time, pathological condition of the gastric mucosa of congo red border was studied. Spraying the congo red solution onto the gastric mucosa, the black spotty mucosa was observed, (black colored island), mainly on lesser carvature. The distribution-grade of black spots was classified in 4 grades from grade-0 to 3. Grade-0 means no black spot and grade-3 means the presence of many black spots. The border of pattern C-i was almost clearly distinguished. But it became irregular in pattern C-2 or C-3, and many black spots were observed. Contrary, black spots disappeared in open type of congo red pattern. Histological studies were made on this black spotty mucosa, adjacent mucosa and Congo red border. Histological studies on the biopsy specimens taken from the black spotty mucosa showed that 50% of the black spots consisted of the mucosa in intermediate zone and 40.4% of these spots of the f undic gland mucosa. On the other hand, 44% of the adjacent mucosa consisted of the mucosa in intermediate zone. About a halt of the biopsy specimens taken from the congo red border showed the mucosa in intermediate zone. Inflammation in the black spotty mucosa was slight as compared with the adjacent mucosa. Magnifying observation of atrophic border was carried out by using magnifying endoscope (FGS-ML, Machida Co.) and dissecting microscope. Sakaki, one of our coleaques, already reported the presense of f oveolointermediate pattern (FIP) which was transitional pattern between FP and FSP, which were proposed by Yoshii. In many of the cases, FIP observed on the histological intermediate zone at this time. In the area of FIP, inflammation was remarkably seen in comparison to the othe sites. Studies were make how to detect the intermediate zone endoscopically. The term of endoscopic atrophic border had already reported by Takemoto et al. While there are few reports about the detection of intermediate zone by using endoscope. Therefore, our trials, which was mentioned above, can conclude that the black spotty area should be identified as the "endoscopic intermediate zone".