Background. Blue laser imaging (BLI) enables the acquisition of more information from tumors� surfaces compared with white light\nimaging. Few reports confirm the validity of magnifying endoscopy (ME) with BLI (ME-BLI) for early gastric cancer (EGC). We\naimed to assess the detailed endoscopic findings from EGCs using ME-BLI. Methods. We enrolled 386 consecutive patients with\n417 EGCs that were diagnosed using ME-BLI and resected by endoscopic submucosal dissection. Using the VS classification\nsystem, three highly experienced endoscopists (HEEs) and three less experienced endoscopists (LEEs) evaluated the demarcation\nline (DL), microsurface pattern (MSP), and microvascular pattern (MVP) within the endoscopic images of EGCs obtained using\nME-BLI, assigning high-confidence (HC) or low-confidence (LC) levels. We investigated the clinicopathological features\nassociated with each confidence level. Results. The HEEs� evaluations determined the presence of DL in 99%, irregular MSP in\n96%, and irregular MVP in 96%, and the LEEs� evaluations determined the presence of DL in 98%, irregular MSP in 95%, and\nirregular MVP in 95% of the EGCs. When DL was present, HC levels in the Helicobacter pylori- (H. pylori-) eradicated group\nand noneradicated group were evident in 65% and 89%, a difference that was significant (p < 0 001). Conclusions. In the\ndiagnosis of EGC with ME-BLI, the VS classification system with ME-NBI can be applied, but identifying the DL after H. pylori\nwas difficult.
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