2007 Volume 49 Issue 1 Pages 12-20
Background : A detail demarcation line diagnosis of esophago-gastric tumor has become important by inventing Endoscopic Submucosal Dissection (ESD). On the other hand, the mucosal surface structure can be observed in detail by enhanced-magnification endoscopy using acetic acid.Aim : The aim of this study was to evaluate usefulness of enhanced-magnification endoscopy for ESD.Subjects and Method : Subjects were 53 lesions. There were one superficial Barrett's esophageal adenocarcinoma lesion, 34 early gastric cancer lesions, and 18 gastric adenoma lesions. Usefulness of demarcation line diagnosis of tumor by enhanced-magnification endoscopy for ESD was investigated.Result : In depressed type tumors, demarcation lines diagnosis of tumors by enhanced-magnification endoscopy were useful in all lesions. In elevated-type lesions, it was useful in only 24% lesions. In the cases with clear demarcation line of tumors by enhanced-magnification endoscopy, the diagnosis of tumor demarcation lines was corresponding to the pathological diagnosis by the resected specimens. There were two lesions which were able to avoid positive lateral margin by enhanced-magnification endoscopy for ESD.Conclusion : Enhanced-magnification endoscopy for ESD was able to observe the demarcation lines of early cancers and adenomas in detail, especially in tumors of the depressed type, and may be useful to avoid positive lateral margin.
