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Pit Pattern (pit + pattern)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

MAGNIFYING ENDOSCOPY WITH NARROW BAND IMAGING FOR EARLY DIFFERENTIATED GASTRIC ADENOCARCINOMA

DIGESTIVE ENDOSCOPY, Issue 3 2008
Kazuyoshi Yagi
We have been using magnifying endoscopy with narrow band imaging (NBI) to study early differentiated gastric adenocarcinomas and to assess the relationship between microvessel pattern, pit pattern and histological pattern. The magnified view of the cancerous area showed three types of pattern: (i) a mesh pattern, consisting of mesh-like connected microvessels; (ii) a loop pattern, consisting of loop-like microvessels that were not connected and had tubule-like or villus-like mucosal structures along them; and (iii) an interrupted pattern, consisting of interrupted thick or thin vessels without mucosal structures. The mesh type of microvascular pattern showed a round pit pattern in 88.9% of cases (32/36) and the loop type of microvascular pattern showed a non-round pit pattern in 100% of cases. Among lesions that showed a mesh pattern or a loop pattern, 94.9% (56/59) were mucosal cancer and 5.1% (3/59) were submucosal cancer. However, 92.3% (12/13) of lesions that showed an interrupted pattern were submucosal differentiated adenocarcinoma and 7.7% (1/13) were mucosal differentiated adenocarcinoma. The present findings provide basic data on the characteristics of mucosal differentiated gastric adenocarcinoma revealed by magnifying endoscopy with NBI, as well as invasive changes such as submucosal invasion. [source]

Relationship between histopathological features and type V pit pattern determined by magnifying videocolonoscopy in early colorectal carcinoma

DIGESTIVE ENDOSCOPY, Issue 2 2005
Shiro Oka
Background: The aim of the present study was to clarify the relationship between the histopathological features and type V pit pattern of early colorectal carcinoma. Methods: We examined the relationship between the type V pit pattern subtypes, the depth of submucosal invasion and the degrees of desmoplastic reaction, residual pit density and destruction of the intervening membrane between pits on the tumor surface in 135 cases of early colorectal carcinoma. The examinations involved magnifying videoendoscopy with indigo carmine dye spraying and crystal violet staining. The pit patterns were classified as one of two grades (VI, VN), and VN was further divided into three subtypes (A, B and C). The data obtained were evaluated by ,2 test, with significance accepted at < 0.05% for each analysis. Results: There were 64 VI, 24 VN -A, 28 VN -B and 19 VN -C lesions. The incidence of massive submucosal invasion (sm2, sm3) was significantly higher in VN -B and VN -C lesions than in VI and VN -A lesions (P < 0.05). Among VN pit pattern lesions, depth of submucosal invasion of VN -B and VN -C lesions was significantly greater than that of VN -A lesions (P < 0.01). The incidence of severe desmoplastic reaction in VN -B and VN -C lesions was significantly greater than that in VI lesions (P < 0.01). The incidence of severe desmoplastic reaction in VN -C lesions was significantly greater than that in VN -A lesions (P < 0.05). The incidence of low residual pit density in VN -C lesions was significantly greater than that in all other type V lesions. The incidence of mild to moderate and severe destruction of the intervening membrane between pits in VN lesions was significantly higher than that in VI lesions. Conclusions: Type V pit pattern subclassification is useful for predicting the depth of submucosal invasion in early colorectal carcinomas. The type V pit pattern subtypes are related to the degrees of desmoplastic reaction, the residual pit density and destruction of the intervening membrane between pits on the tumor surface. [source]

Diagnosis of invasion depth in early colorectal carcinoma by pit pattern analysis with magnifying endoscopy

DIGESTIVE ENDOSCOPY, Issue 2001
Shinji Tanaka
Background: The aim of this study was to clarify whether various pit patterns on the surface of colorectal tumors are associated with various levels of submucosal invasion. Methods: We examined pathologic features of the pit pattern of the tumor surface in 457 colorectal adenomas and early carcinomas. The examinations involved the use of magnifying endoscopy with indigocarmine dye spraying or crystal violet staining methods. Regarding the pit pattern classification, we used the types I, II, IIIL, IIIS, IV, VA and VN. We subclassified the VN pit pattern according to the area of the tumor surface covered into grades A (small), B (medium) and C (large). Results: Magnifying colonoscopic observation revealed the rates of submucosal invasion associated with specific pit patterns to be 1% (3/213) for IIIL, 5% (2/42) for IIIS, 8% (4/57) for IV, 14% (13/93) for VA and 80% (42/52) for VN. The rates of submucosal massive invasion (> 400 ,m) associated with specific pit patterns was 0% (0/213) for IIIL, 0% (0/42) for IIIS, 4% (2/57) for IV, 5% (5/93) for VA and 72% (38/52) for VN. Within the VN pit pattern subclassification, the incidence of submucosal invasion , 1500 ,m was found each grade (A, B & C): 5% (1/19) for grade A, 64% (14/22) for grade B and 93% (13/14) for grade C. Conclusion: Determination of pit pattern is useful for prediction of submucosal invasion depth and for decisions concerning treatment in colorectal tumors. Lesions with VA and non-grade C VN pit patterns are candidates for total endoscopic resection. A grade C VN pit pattern is a definite indicator of severely invasive submucosal carcinoma, which is unresectable by endoscopic resection. [source]

Diagnosis of depth of invasion for early colorectal cancer using magnifying colonoscopy

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2010
Hisatomo Ikehara
Abstract Background and Aims:, Early colorectal cancer (CRC) with submucosal deep (s.m.-d.) invasion should not be treated with endoscopic mucosal resection due to the higher incidence of lymph-node metastasis. It is, therefore, clinically important to accurately diagnose s.m.-d. lesions before treatment. Methods:, We analyzed the endoscopic features, including pit patterns, of early CRC with s.m.-d. invasion observed using magnifying colonoscopy. We retrospectively investigated 379 cases of early CRC. Lesions were divided into three macroscopic subtypes (pedunculated type, sessile type and superficial type) based on endoscopic findings. Eight endoscopic factors were evaluated retrospectively for association with s.m. invasion and then compared to histopathological findings. Results:, The superficial type had a significantly higher frequency of s.m.-d. invasion (52.4% [77/147] vs 24.6% [14/57] and 39.4% [69/175], P -value < 0.05, respectively, for pedunculated and sessile types). Based on multivariate analysis, an independent risk factor for s.m.-d. invasion was the existence of an invasive pit pattern in sessile and superficial types (odds ratios of 52.74 and 209.67, respectively). Fullness was also an independent risk factor for s.m.-d. invasion in the superficial type (odds ratio = 9.25). There were no independent risk factors for s.m.-d. invasion in the pedunculated type. Conclusion:, High magnification pit pattern diagnosis proved to be useful for predicting s.m.-d. invasion in sessile and superficial types although it was not as helpful with the pedunculated type. [source]

Diagnosis of invasion depth in early colorectal carcinoma by pit pattern analysis with magnifying endoscopy

DIGESTIVE ENDOSCOPY, Issue 2001
Shinji Tanaka
Background: The aim of this study was to clarify whether various pit patterns on the surface of colorectal tumors are associated with various levels of submucosal invasion. Methods: We examined pathologic features of the pit pattern of the tumor surface in 457 colorectal adenomas and early carcinomas. The examinations involved the use of magnifying endoscopy with indigocarmine dye spraying or crystal violet staining methods. Regarding the pit pattern classification, we used the types I, II, IIIL, IIIS, IV, VA and VN. We subclassified the VN pit pattern according to the area of the tumor surface covered into grades A (small), B (medium) and C (large). Results: Magnifying colonoscopic observation revealed the rates of submucosal invasion associated with specific pit patterns to be 1% (3/213) for IIIL, 5% (2/42) for IIIS, 8% (4/57) for IV, 14% (13/93) for VA and 80% (42/52) for VN. The rates of submucosal massive invasion (> 400 ,m) associated with specific pit patterns was 0% (0/213) for IIIL, 0% (0/42) for IIIS, 4% (2/57) for IV, 5% (5/93) for VA and 72% (38/52) for VN. Within the VN pit pattern subclassification, the incidence of submucosal invasion , 1500 ,m was found each grade (A, B & C): 5% (1/19) for grade A, 64% (14/22) for grade B and 93% (13/14) for grade C. Conclusion: Determination of pit pattern is useful for prediction of submucosal invasion depth and for decisions concerning treatment in colorectal tumors. Lesions with VA and non-grade C VN pit patterns are candidates for total endoscopic resection. A grade C VN pit pattern is a definite indicator of severely invasive submucosal carcinoma, which is unresectable by endoscopic resection. [source]

Diagnosis of depth of invasion for early colorectal cancer using magnifying colonoscopy

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2010
Hisatomo Ikehara
Abstract Background and Aims:, Early colorectal cancer (CRC) with submucosal deep (s.m.-d.) invasion should not be treated with endoscopic mucosal resection due to the higher incidence of lymph-node metastasis. It is, therefore, clinically important to accurately diagnose s.m.-d. lesions before treatment. Methods:, We analyzed the endoscopic features, including pit patterns, of early CRC with s.m.-d. invasion observed using magnifying colonoscopy. We retrospectively investigated 379 cases of early CRC. Lesions were divided into three macroscopic subtypes (pedunculated type, sessile type and superficial type) based on endoscopic findings. Eight endoscopic factors were evaluated retrospectively for association with s.m. invasion and then compared to histopathological findings. Results:, The superficial type had a significantly higher frequency of s.m.-d. invasion (52.4% [77/147] vs 24.6% [14/57] and 39.4% [69/175], P -value < 0.05, respectively, for pedunculated and sessile types). Based on multivariate analysis, an independent risk factor for s.m.-d. invasion was the existence of an invasive pit pattern in sessile and superficial types (odds ratios of 52.74 and 209.67, respectively). Fullness was also an independent risk factor for s.m.-d. invasion in the superficial type (odds ratio = 9.25). There were no independent risk factors for s.m.-d. invasion in the pedunculated type. Conclusion:, High magnification pit pattern diagnosis proved to be useful for predicting s.m.-d. invasion in sessile and superficial types although it was not as helpful with the pedunculated type. [source]