A new diagnostic VS classification system produced by magnification endoscopy plus narrow-band imaging in the stomach: Microvascular architecture and microsurface structure

Abstract

We review the clinical application of magnification endoscopy with white light imaging and narrow-band imaging in the stomach. Basically, the microvascular architecture is visualized by magnification endoscopy with white light imaging; in addition, the microsurface structure can be visualized by magnification, endoscopy. The basic principles for the analysis of magnification endoscopy are that we should describe the magnification endoscopy findings independently based on the two distinct microanatomies, that is, the microvascular architecture (V) and the microsurface structure (S). Then, we should integrate these two findings into various categories to enable a correct diagnosis of gastrointestinal pathology. Based on these principles, for the new diagnostic system produced by magnification endoscopy and narrowband imaging, we propose a simple classification system for making a correct diagnosis between cancerous and noncancerous pathology. The criterion for cancerous pathology is the presence of either an irregular microvascular pattern or an irregular microsurface pattern. Such a simple classification system is mandatory for the establishment of a scientific diagnostic system, which can be successfully utilized by all endoscopists. © 2008 Springer Japan.