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Reiko Kimura-Tsuchiya [1; 2] and Osamu Dohi [1] and Yasuko Fujita [3] and Nobuaki Yagi [1; 4] and Atsushi Majima [1] and Yusuke Horii [1] and Tomoko Kitaichi [1] and Yuriko Onozawa [1] and Kentaro Suzuki [1] and Akira Tomie [1] and Tetsuya Okayama [1] and Naohisa Yoshida [1] and Kazuhiro Kamada [1] and Kazuhiro Katada [1] and Kazuhiko Uchiyama [1] and Takeshi Ishikawa [1] and Tomohisa Takagi [1] and Osamu Handa [1] and Hideyuki Konishi [1] and Mitsuo Kishimoto [5] and Yuji Naito [1] and Akio Yanagisawa [5] and Yoshito Itoh [1]

Academic Editor: Tatsuya Toyokawa

1, Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan, kanazawa-u.ac.jp

2, Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan, fmu.ac.jp

3, Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine, Kyoto, Japan, kpu-m.ac.jp

4, Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, Gifu, Japan, asahi-u.ac.jp

5, Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan, kpu-m.ac.jp

Received May 15, 2017; Accepted Jul 18, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is commonly performed worldwide as a standard therapy [1]. In the Japanese gastric cancer treatment guidelines, pathological diagnosis is essential to decide ESD indication [2, 3].

Image-enhanced endoscopy is performed for the diagnosis of gastric lesions because of its accuracy and applicability. Magnifying endoscopy with narrow-band imaging (ME-NBI) has a high diagnostic accuracy of superficial gastric lesions compared with white-light imaging endoscopy [4–7], because ME-NBI can also visualize the microstructures and microvessels of the EGCs.

Blue laser imaging (BLI) has recently been developed as a combination of two kinds of laser lights for narrow-band light observation. Magnifying endoscopy with BLI (ME-BLI) is useful for evaluating mucosal surfaces, including surface blood vessels and structure patterns [8–12]. We previously reported the usefulness of ME-BLI for the diagnosis of EGC compared with white-light imaging endoscopy [13]. In another study of ours, we reported that there were differences in 15 of 90 EGCs (16.7%) in microstructure visualization between ME-BLI and ME-NBI. In...

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