Chiyuki Watanabe

Gastric Acid Secretion, Serum Pepsinogen I, and Serum Gastrin in Japanese with Gastric Hyperplastic Polyps or Polypoid-Type Early Gastric Carcinoma

We determined the maximum secretion of gastric acid and the fasting serum levels of pepsinogen I and gastrin in Japanese patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma, comparing those findings with observations in control subjects. Both the maximum acid secretion and fasting levels of serum pepsinogen I were significantly lower in the patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma than in the controls. Fasting serum gastrin levels were significantly higher in the patients with gastric hyperplastic polyps than in the other two groups of subjects. These data demonstrated that the combination of hypochlorhydria, a low level of pepsinogen I, and hypergastrinemia (type-A gastritis) was common in the patients with gastric hyperplastic polyps, whereas hypochlorhydria and a low pepsinogen I without hypergastrinemia (type-B gastritis) were common in those with polypoid-type early gastric carcinoma.

Magnifying colonoscopy used to predict disease relapse in patients with quiescent ulcerative colitis.

Background: Many patients with quiescent ulcerative colitis (UC) experience relapse. However, clinical and conventional colonoscopic signs are inadequate for predicting relapse. This studys aim was to investigate the effectiveness of magnifying colonoscopy in predicting relapse in patients with quiescent UC and to evaluate the association of the findings of magnifying colonoscopy with the histological findings. Methods: Magnifying colonoscopy was performed in 57 patients with clinical and endoscopic inactive UC. Patients were divided into 3 groups according to the findings of magnifying colonoscopy as MR (magnify‐regular), MI (magnify‐irregular), and MD (magnify‐defect). Their subsequent clinical course was compared to assess the clinical usefulness of magnifying observation in predicting relapse. We also compared histological findings according to Rileys criteria to each finding of magnifying colonoscopy. Results: Within 12 months, 1 of 18 patients (6.7%), 10 of 22 patients (45.5%), and 12 of 17 patients (70.6%) with findings of magnifying colonoscopy of MR, MI, and MD, respectively, experienced relapse. The MR group had a significantly low relapse rate compared with the MD and MI groups (P = 0.016, P = 0.002). When histological findings were compared with the findings of magnifying colonoscopy, the mean score of each variable, such as acute inflammatory cell infiltrate, chronic inflammatory cell infiltrate, and crypt architectural irregularities was significantly lower in the MR group than in the MD and MI groups. Conclusions: The findings of magnifying colonoscopy in patients with quiescent UC is useful for predicting relapse and is associated with histological grade of inflammation. Inflamm Bowel Dis 2009

Sa1585 The Corresponding Rate of Magnification Observation Findings of Narrow Band Imaging (NBI) and Flexible Spectral Imaging Color Enhancement (FICE) in Gastric Tumors and in Colorectal Lesions

The Corresponding Rate of Magnification Observation Findings of Narrow Band Imaging (NBI) and Flexible Spectral Imaging Color Enhancement (FICE) in Gastric Tumors and in Colorectal Lesions Yuko Hiraga*, Masaaki Sumioka, Tomoki Hiramoto, Morihisa Akagi, Daisuke Komichi, Yukio Kuwada, Mikiya Kitamoto, Chiyuki Watanabe, Takashi Nishisaka Department of endoscopy, Hiroshima prefectural Hospital, Hirosima, Japan; Department of gastroenterology, Hiroshima prefectural Hospital, Hirosima, Japan; Department of pathology, Hiroshima prefectural Hospital, Hirosima, Japan Introduction/Objectives: There is a difference in how to see the microvessels by NBI and FICE for the reason that the method of the image enhancement is different, so that it has not been clear whether NBI magnification classification can apply to FICE also. We have been able to use both the instruments in our hospital, so that we were able to do the comparative study of NBI findings and FICE ones at the same lesions for the purpose of examining whether the classification of NBI magnification fits FICE magnification findings also. Methods: We examined a total of 161 lesions (22 gastric tumors, 139 colorectal lesions) that observed by both NBI magnification and FICE magnification between April 2009 and August 2011, treated by endoscopic or surgical resection and diagnosed clinicopathologically. The interval of NBI and FICE examinations was 62.3days (shortest one day, longest 475 days). We examined on the comparison with the NBI findings and the FICE ones and on the relationship between them and histological diagnosis. We classified NBI/FICE magnifying findings according to whether surface pattern was visible or not and whether that was regular or not, and whether microvessels were regular or not and whether avascular area appeared or not. We followed VS classification system (Vascular pattern; regular, irregular or absent, Surface pattern; regular, irregular or absent) in gastric tumors, and followed Hiroshima classification (A, B, C1, C2 or C3) in colorectal lesions. Results: 1) Gastric tumors: In surface pattern diagnosis, FICE findings corresponded with NBI ones at all 22 lesions. But in microvessels pattern diagnosis, evaluations differed in two lesions (regular-irregular, regular-absent). The corresponding rate of NBI and FICE magnification findings was overall 90.9% in gastric tumors, in each of histological diagnosis, it was 91.7% in adenomas, and 90.0% in cancers. 2) Colorectal lesions: The diagnoses of FICE findings differed from NBI ones in 16 lesions, concretely A-B 1 lesion, B-C1 13 lesions and C1-C2 2 lesions. The diagnoses of C3-type, with invisible surface pattern and fragmental microvessels or avascular area, corresponded in all 6 lesions. The corresponding rate of NBI and FICE magnification findings was overall 88.5% in colorectal lesions, in each of histological diagnosis, it was 100% in non-neoplasm, 89.6% in adenomas, 90.5% in intramucosal cancers, and 66.7% in invasive cancers. Conclusions: In gastric tumors and colorectal lesions, the diagnoses between NBI magnification and FICE ones almost corresponded. We were able to apply the classification of NBI magnification to also FICE magnification by using the classification that paid attention to a visibility of surface pattern and to an irregularity of microvessels diameter and distribution.