Usefulness of the DL in ME with NBI for determining the expanded area of early-stage differentiated gastric carcinoma

Figure 1 Narrow band imaging findings. A: Ordinary [non magnifying endoscopy with narrow band imaging (ME-NBI)] endoscopic findings of intramucosal gastric carcinoma. A flare-like flat-type (0-IIb) lesion measuring 25 mm in diameter, with an unclear border, was observed at the greater curvature of the inferior gastric body (arrows); B: NBI finding of the lesion (non-ME); C: Strongly-magnified NBI finding at the lesion center; D: Moderately-magnified NBI finding at the margin: a demarcation line between the cancerous and non-cancerous regions could be recognized based on differences in the fine structure of mucosa and microvascular features (arrows). This was established as an imaginary boundary.

Figure 2 Biopsy findings and standard observation biopsy. A: As shown in the photograph, biopsy was performed by measuring a distance of approximately 1.8 mm using forceps (tip diameter: 1.8 mm), regarding two regions sandwiching the boundary estimated on NBI as cancerous and non-cancerous; B: Standard observation after biopsy.

Figure 3 Pathological findings. A: HE staining of a biopsy specimen collected from the demarcation line (DL) (+) site of the patient presented in Figure 2; B: HE staining of a biopsy specimen collected from the DL (-) site of the patient presented in Figure 2.