Differences In The Microsurface And Microvascular Features Between Early Gastric Cancer Of Corpus And Antrum Under Narrow Band Imaging Magnifying Endoscopy

Background and Aims:Magnifying endoscopy with narrow band imaging?ME-NBI?has proved to be helpful for the diagnosis of the early gastric cancer?EGC?,which can yield very clear magnifying endoscopic images in which microsurface structure?MS?and microvascular features?MV?can be identified.According to these information,clinicians can reach an accurate diagnosis and provide the reliable foundation for the following clinical treatment.MS and MV patterns of early gastric cancer are associated with the histologic type,invasion depth and macroscopic shape of lesions.It is well known that there are significant differences in MS and MV patterns between the mucosa of normal antrum and corpus under ME-NBI.Normal corporal mucosa displays a regular honeycomb-like subepithelial capillary network and regular oval crypt opening with circular marginal crypt epithelium.Normal antral mucosa appears as a regular coil-shaped subepithelial capillary network and regular polygonal or curved marginal crypt epithelium.However,no studies have reported the lesion location's influence on the microvascular and microsurface features of EGC.Therefore,the aim of this study is to clarify the significant differences between the EGCs of the corpus and the antrum under ME-NBI.Methods:This was a retrospective study including 103 patients with EGC between September 2014 and February 2019.According to the lesion location,patients were divided into 2 groups:antrum type and corpus type.After adjusting the confounding factors such as degree of differentiation,invasion depth and macroscopic shape of lesions with ordinal ploytomous logistic regression and case control matching,the differences of MS and MV features were evaluated between those 2 groups.Results:According to the Sakaki's classification,MS of EGCs presented as IV,V₁ or VI type.Tumor location and differentiated degree were identified as independent predictors for MS structure.The corpus was 6.13 times of the possibility that the classification categories of MS patterns in EGCs were at least one grade higher than antrum??²=8.42,P=0.004,95%CI 1.80-20.86?,and undifferentiated-type EGCs was5.80 times of the possibility than differentiated-type EGCs??²=7.13,P=0.008,95%CI1.60-21.05?.No difference in the MV patterns of EGCs was observed between antrum and corpus group?P=0.3?,while the VS patterns?FNP,ILL-1,ILL-2 and CSP?were significantly different between those 2 groups?P=0.03?.Conclusions:There were significant differences in the MS and VS pattern of EGC between antrum and corpus types.The characteristics of EGC in antrum are less obvious than in corpus.Therefore,antral EGC is more likely to be missed in clinical gastroscopy.